Airway responsiveness to mannitol 24 h after allergen challenge in atopic asthmatics

Davis, Beth E.; Amakye, D. O.; Cockcroft, Donald W.

doi:10.1111/all.12601

Cited by 7 publications

(16 citation statements)

References 23 publications

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“…Finally, we used methacholine to assess AHR as it is part of this standardized model. Mannitol could have been an alternative, but in one of our recent studies, mild subjects were often negative to mannitol challenge and did not correlate with methacholine .…”

Section: Discussionmentioning

confidence: 85%

Allergen‐induced early and late asthmatic responses to inhaled seasonal and perennial allergens

Boulet

Gauvreau

Boulay

et al. 2015

Clin Experimental Allergy

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Section: Discussionmentioning

confidence: 85%

Allergen‐induced early and late asthmatic responses to inhaled seasonal and perennial allergens

Boulet

Gauvreau

Boulay

et al. 2015

Clin Experimental Allergy

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“…We began by identifying 46 unique individuals from four studies performed in our laboratory. We included the 20 subjects from the most recent study [29], 18 (of 20) additional subjects from a second study [26] and 8 (of 20) subjects from two allergen challenge studies [27,28]. For analysis we selected the first methacholine challenge performed in the four studies, the only mannitol study by the standard method [3] from 2 studies [26,29] and the pre-allergen mannitol challenge from the two allergen challenge studies [27,28].…”

Section: Saskatoon Studiesmentioning

confidence: 99%

“…We included the 20 subjects from the most recent study [29], 18 (of 20) additional subjects from a second study [26] and 8 (of 20) subjects from two allergen challenge studies [27,28]. For analysis we selected the first methacholine challenge performed in the four studies, the only mannitol study by the standard method [3] from 2 studies [26,29] and the pre-allergen mannitol challenge from the two allergen challenge studies [27,28]. The methacholine challenges were done with the two minute tidal breathing method [34] in three studies [26][27][28] and by the tidal breathing vibrating mesh nebulizer volumetric method (0.5 mL methacholine nebulized to completion, 1.5 to 2.5 min tidal breathing) [35] in one [29].…”

Section: Saskatoon Studiesmentioning

confidence: 99%

“…For analysis we selected the first methacholine challenge performed in the four studies, the only mannitol study by the standard method [3] from 2 studies [26,29] and the pre-allergen mannitol challenge from the two allergen challenge studies [27,28]. The methacholine challenges were done with the two minute tidal breathing method [34] in three studies [26][27][28] and by the tidal breathing vibrating mesh nebulizer volumetric method (0.5 mL methacholine nebulized to completion, 1.5 to 2.5 min tidal breathing) [35] in one [29]. A normal result is a provocation concentration causing a fall in forced expired volume in 1 s (FEV 1 ) of 20% (PC 20 ) of > 16 mg/mL for the former method [34] and non-cumulative provocation dose causing a 20% FEV 1 fall (PD 20 ) of > 400 μg for the latter [35].…”

Section: Saskatoon Studiesmentioning

confidence: 99%

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Comparison of methacholine and mannitol challenges: importance of method of methacholine inhalation

Cockcroft

Davis

Blais

2020

Allergy Asthma Clin Immunol

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Background: Direct inhalation challenges (e.g. methacholine) are stated to be more sensitive and less specific for a diagnosis of asthma than are indirect challenges (e.g. exercise, non-isotonic aerosols, mannitol, etc.). However, data surrounding comparative sensitivity and specificity for methacholine compared to mannitol challenges are conflicting. When methacholine is inhaled by deep total lung capacity (TLC) inhalations, deep inhalation inhibition of bronchoconstriction leads to a marked loss of diagnostic sensitivity when compared to tidal breathing (TB) inhalation methods. We hypothesized that deep inhalation methacholine methods with resulting bronchoprotection may be the explanation for conflicting sensitivity/specificity data. Methods:We reviewed 27 studies in which methacholine and mannitol challenges were performed in largely the same individuals. Methacholine was inhaled by dosimeter TLC methods in 13 studies and by tidal breathing in 14 studies. We compared the rates of positive methacholine (stratified by inhalation method) and mannitol challenges in both asthmatics and non-asthmatics.Results: When methacholine was inhaled by TLC inhalations the prevalence of positive tests in asthmatics, 60.2% (548/910), was similar to mannitol, 58.9% (537/912). By contrast, when methacholine was inhaled by tidal breathing the prevalence of positive tests in asthmatics 83.1% (343/413) was more than double that of mannitol, 41.5% (146/351). In non-asthmatics, the two methacholine methods resulted in positive tests in 18.8% (142/756) and 16.2% (27/166) by TLC and TB inhalations respectively. This compares to an overall 8.3% (n = 76) positive rate for mannitol in 913 non-asthmatics. Conclusion:These data support the hypothesis that the conflicting data comparing methacholine and mannitol sensitivity and specificity are due to the method of methacholine inhalation. Tidal breathing methacholine methods have a substantially greater sensitivity for a diagnosis of asthma than either TLC dosimeter methacholine challenge methods or mannitol challenge. Methacholine challenges should be performed by tidal breathing as per recent guideline recommendations. Methacholine (more sensitive) and mannitol (more specific) will thus have complementary diagnostic features.

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“…Mimo nieznacznego wzrostu stężenia FeNO w powietrzu wydychanym nie zaobserwowano zwiększenia BHR. Według autorów proces ten nie został do końca wyjaśniony i wymaga dalszych badań [55].…”

Section: Diagnostyka Astmy Zawodowejunclassified

The usefulness of bronchial challenge tests in the diagnosis of occupational asthma

Nowakowska‐Świrta

Wiszniewska

Walusiak‐Skorupa

2018

Med Pr

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Bronchial hyperresponsiveness (BHR) is the individual ability to respond with bronchoconstriction to a variety of specific and nonspecific stimuli which do not cause these symptoms among healthy subjects. Bronchial hyperresponsiveness is one of the hallmark features of asthma. The degree of bronchial hyperresponsiveness is variable among individuals with asthma and may correlate to its severity (the more severe asthma the higher bronchial hyperreactivity). Bronchial hyperresponsiveness is evaluated by performing bronchial provocation test (BPT). Provocation tests are classified - according to their mechanisms - into direct and indirect tests. Direct challenge tests are highly sensitive and they are used primarily to rule out asthma. In contrast, provocation tests with indirect stimuli are less sensitive but more specific to the direct tests; they are used generally to confirm the diagnosis of asthma and they allow for more accurate conclusions about inflammatory lesions in the case of a patient. Bronchial provocation tests play a significant role in occupational medicine. They are particularly relevant to be performed prior to employment, during periodic examinations, and to diagnose and monitor both occupational asthma and work-related asthma. This article presents selected bronchial provocation tests and their usefulness in the diagnosis of occupational asthma. Med Pr 2018;69(4):457-471.

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Airway responsiveness to mannitol 24 h after allergen challenge in atopic asthmatics

Cited by 7 publications

References 23 publications

Allergen‐induced early and late asthmatic responses to inhaled seasonal and perennial allergens

Allergen‐induced early and late asthmatic responses to inhaled seasonal and perennial allergens

Comparison of methacholine and mannitol challenges: importance of method of methacholine inhalation

The usefulness of bronchial challenge tests in the diagnosis of occupational asthma

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