Standardized challenge testing with pharmacological, physical and sensitizing stimuli in adults

Sterk, PJ; Fabbri, Leonardo; Quanjer, P. H.; Cockcroft, Don; O'Byrne, Paul M.; Anderson, Sandra D.; Juniper, E. F.; Jl, Malo

doi:10.1183/09041950.053s1693

Cited by 851 publications

(594 citation statements)

References 197 publications

(254 reference statements)

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“…At the initial visit, the patient's inhalation technique with Turbuhaler1 (Astra Draco, Lund, Sweden) and Diskhaler1 (GlaxoWellcome, Zeist, The Netherlands) was optimalized according to the instructions of the manufacturer. A methacholine provocation test was performed in a standardized manner, however, the methacholine challenge was continued until a reduction of at least 30% in FEV1 was reached [11]. In brief, methacholine challenges were performed using a Wiesbadener Doppelinhalator giving an output of 0.2 mL in 2 min.…”

Section: Methodsmentioning

confidence: 99%

Comparison of formoterol, salbutamol and salmeterol in methacholine-induced severe bronchoconstriction

Politiek¹,

Boorsma²,

Aalbers³

1999

Eur Respir J

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Comparison of formoterol, salbutamol and salmeterol in methacholine-induced severe bronchoconstriction. M.J. Politiek, M. Boorsma, R. Aalbers. #ERS Journals Ltd 1999. ABSTRACT: The onset of the bronchodilating effect of formoterol (12 mg by Turbuhaler1) was compared with that of salbutamol (50 mg by Turbuhaler), salmeterol (50 mg by Diskhaler1) and placebo in methacholine-induced severe bronchoconstriction.Seventeen subjects with mild-to-moderate asthma completed this randomized, double blind, cross-over, double-dummy study. On four study days, baseline forced expiratory volume in one second (FEV1) was recorded and the subjects were challenged with methacholine until FEV1 fell by at least 30%. Immediately thereafter, the study drugs were inhaled and lung function was assessed for 60 min.The geometric mean time for FEV1 to return to 85% of baseline was 7.2 min with formoterol, 6.5 min with salbutamol, 14.1 min with salmeterol and 34.7 min with placebo (p=0.0001, overall ANOVA). The difference between formoterol and salmeterol was statistically significant (p=0.01); there was no difference between formoterol and salbutamol (p=0.69).In conclusion, formoterol reversed methacholine-induced severe bronchoconstriction as rapidly as salbutamol and more rapidly than salmeterol. Classifying b 2 -agonists as "fast"-and "slow"-acting may be supplemental to "short"-and "long"-acting. Eur Respir J 1999; 13: 988±992.

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Section: Methodsmentioning

confidence: 99%

Comparison of formoterol, salbutamol and salmeterol in methacholine-induced severe bronchoconstriction

Politiek¹,

Boorsma²,

Aalbers³

1999

Eur Respir J

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“…Asthma was excluded by a negative methacholine test, in accordance with international guidelines [23]. All patients tested negative to the skin prick test with a standard panel of ten allergen sources common to Sweden.…”

Section: Subjectsmentioning

confidence: 99%

Inhaled ethanol potentiates the cough response to capsaicin in patients with airway sensory hyperreactivity

Millqvist

Ternesten-Hasséus

Bende

2008

Pulmonary Pharmacology & Therapeutics

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To cite this version:Eva Millqvist, Ewa Ternesten-Hasséus, Mats Bende. Inhaled ethanol potentiates the cough response to capsaicin in patients with airway sensory hyperreactivity. Pulmonary Pharmacology & Therapeutics, 2008, 21 (5) This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting galley proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. A c c e p t e d m a n u s c r i p t 4

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“…In 1993, the European Respiratory Society (ERS) [29] published recommendations for bronchial challenge tests, indicating that complete information from a bronchial challenge test with pharmacologic agents can only be obtained from analysis of the shape of the dose-response curve (DRC). It is clearly stated in this report that, although PD or PC indicates the position of the DRC, the slope and the degree of maximal obstruction provide relevant information about the level and potential severity of bronchial response [9,27,29].…”

Section: Introductionmentioning

confidence: 99%

“…It is clearly stated in this report that, although PD or PC indicates the position of the DRC, the slope and the degree of maximal obstruction provide relevant information about the level and potential severity of bronchial response [9,27,29]. Woolcock et al [34] were the first to demonstrate that the shape of DRC in asthmatics was different from that of normals, i.e.…”

Section: Introductionmentioning

confidence: 99%

“…many asthmatics show a higher slope and a higher maximal response or plateau when exposed to high doses of methacholine, histamine, or other inhaled bronchoconstrictors [2,15,21,22,24]. However, although the ERS report [29] considered that maximal DRCs, mandatory for the study of maximal response, can be safely recorded up to a 50% decline in FEV 1 , provided the patients have normal baseline lung function, it is also recommended that this procedure should be limited to research studies. Thus, in a clinical setting, most of the information that can be obtained from bronchial challenge tests with pharmacologic agents comes from the analysis of the early part of the DRC.…”

Section: Introductionmentioning

confidence: 99%

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Methacholine Dose-Response Slopes from Maximal Bronchial Challenge Tests in Asthmatic Children: Methodological Aspects

Gamboa¹,

Neuparth²,

Silva³

et al. 1997

Lung

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Abstract. To determine whether the slope of a maximal bronchial challenge test (in which FEV 1 falls by over 50%) could be extrapolated from a standard bronchial challenge test (in which FEV 1 falls up to 20%), 14 asthmatic children performed a single maximal bronchial challenge test with methacholine (dose range: 0.097-30.08 mol) by the dosimeter method. Maximal dose-response curves were included according to the following criteria: (1) at least one more dose beyond a ⌬FEV 1 ജ 20%; and (2) a MFEV 1 ജ 50%. PD 20 FEV 1 was calculated, and the slopes of the early part of the dose-response curve (standard dose-response slopes) and of the entire curve (maximal dose-response slopes) were calculated by two methods: the two-point slope (DRR) and the least squares method (LSS) in % ⌬FEV 1 × mol −1 . Maximal dose-response slopes were compared with the corresponding standard dose-response slopes by a paired Student's t test after logarithmic transformation of the data; the goodness of fit of the LSS was also determined. Maximal dose-response slopes were significantly different (p < 0.0001) from those calculated on the early part of the curve: DRR 20% (91.2 ± 2.7 ⌬FEV 1 % ⅐ mol −1 ) was 2.88 times higher than DRR 50% (31.6 ± 3.4 ⌬FEV 1 % ⅐ mol −1 ), and the LSS 20% (89.1 ± 2.8% ⌬FEV 1 ⅐ mol −1 ) was 3.10 times higher than LSS 50% (28.8 ± 1.5% ⌬FEV 1 ⅐ mol −1 ). The goodness of fit of LSS 50% was significant in all cases, whereas LSS 20% failed to be significant in one. These results suggest that maximal dose-response slopes cannot be predicted from the data of standard bronchial challenge tests.

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Standardized challenge testing with pharmacological, physical and sensitizing stimuli in adults

Cited by 851 publications

References 197 publications

Comparison of formoterol, salbutamol and salmeterol in methacholine-induced severe bronchoconstriction

Comparison of formoterol, salbutamol and salmeterol in methacholine-induced severe bronchoconstriction

Inhaled ethanol potentiates the cough response to capsaicin in patients with airway sensory hyperreactivity

Methacholine Dose-Response Slopes from Maximal Bronchial Challenge Tests in Asthmatic Children: Methodological Aspects

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