Methacholine bronchial challenge in children

Gg, Shapiro; Ct, Furukawa; We, Pierson; Bierman, C. Warren

doi:10.1016/0091-6749(82)90147-6

Cited by 53 publications

(13 citation statements)

References 9 publications

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“…However, taking account of the higher value of our criteria for increased AR (PC20 <25 mg·mL -1 [18]) compared to those of other studies (PC20 <5 mg·mL -1 [5], PC20 <8 mg·mL -1 [6]), the frequency of increased AR was lower in our study. This may be due to the difference in age of the study population or the technique of measurement of AR (dosimeter method [20] in the present study versus the tidal breathing method [28] in other studies [5,6]).…”

Section: Discussioncontrasting

confidence: 55%

“…The diagnosis of bronchiectasis was based on clinical features and was confirmed by computed tomography, with bronchography when necessary. Among 63 children with bronchiectasis who had been followed up at our clinic and were old enough to perform pulmonary function tests, 27 (43%) were found to have an increased AR, defined as a PC20 <25 mg·mL -1 evaluated by the dosimeter method [18], in the preliminary methacholine challenge test. Two of the children subsequently withdrew from the study because of noncompliance.…”

Section: Subjectsmentioning

confidence: 99%

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Effect of roxithromycin on airway responsiveness in children with bronchiectasis: a double-blind, placebo-controlled study

Koh¹,

Lee²,

Sun³

et al. 1997

Eur Respir J

132

103

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Increased airway responsiveness (AR) is frequently associated with bronchiectasis. Roxithromycin is a new semisynthetic macrolide antibiotic that also has anti-inflammatory activities. This study was designed to see whether roxithromycin could favourably alter the degree of AR in patients with bronchiectasis and increased AR. Twenty five children with bronchiectasis, who had an increased AR (defined as a provocative concentration of methacholine causing a 20% fall in forced expiratory volume in one second (FEV1) (PC20) <25 mg x mL(-1) evaluated by the dosimeter method), were randomized, double-blind into two parallel groups. Thirteen of the children were treated with roxithromycin (4 mg x kg(-1) b.i.d.) for 12 weeks and 12 received placebo. FEV1, sputum purulence and leucocyte scores were assessed every 3 weeks. To estimate AR, high-dose methacholine challenge tests were performed before and after treatment. On the dose-response curve to methacholine, PD20 and maximal response (two indices of AR) were measured. Changes in FEV1 were not observed during the course of the study in both groups. A significant improvement in sputum features was noted after 6 weeks of treatment in the roxithromycin group. After 12 weeks of roxithromycin therapy, the geometric mean (range of 1 SD) of provocative cumulative dose producing a 20% fall in FEV1 (PD20) increased significantly (p<0.01) to 169.2 (83.2-344.2) breath units (BU) (1 BU denotes one inhalation of 1 mg x mL(-1) methacholine) and the mean+/-SD of maximal response decreased significantly (p<0.01) to 32.5+/-6.8%, as compared with the initial values (PD20 87.1 (47.3-160.4) BU; maximal response 40.9+/-7.4%). No significant changes in either parameter were observed in the placebo group. Our results indicate that roxithromycin may decrease the degree of airway responsiveness in patients with bronchiectasis and increased airway responsiveness. Further study is necessary to determine the mechanism by which roxithromycin reduces airway responsiveness in bronchiectasis and its clinical impact.

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Section: Discussioncontrasting

confidence: 55%

Section: Subjectsmentioning

confidence: 99%

Effect of roxithromycin on airway responsiveness in children with bronchiectasis: a double-blind, placebo-controlled study

Koh¹,

Lee²,

Sun³

et al. 1997

Eur Respir J

132

103

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“…In adult asthmatics, symptoms and treatment requirement are closely related to the degree of methacholine bronchial responsiveness [13], whereas in children this relationship is controversial [14,15]. A discrepancy between adults and children with asthma seems also to exist regarding bronchial response to UNDW inhalation.…”

Section: Introductionmentioning

confidence: 99%

Airway Responsiveness to Exercise and Ultrasonically Nebulized Distilled Water in Children: Relationship to Clinical and Functional Characteristics

Foresi

Corbo²,

Valente³

1988

Respiration

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We studied the bronchial response to exercise and ultrasonically nebulized distilled water (UNDW) challenge in 19 normal controls (3 females and 16 males; age 6–13 years) and in 44 asthmatic children (12 females and 32 males; age 6–13 years) in order (1) to determine the sensitivity and specificity of the two challenges and (2) to evaluate the relationship between bronchial responses and clinical and functional characteristics. A 20% fall in FEV₁ was regarded as a significant bronchial response. The specificity of both challenges was high (100%), whereas the sensitivity of exercise (77.3%) was twice that of UNDW (38.6%). The combination of the two challenges increased the sensitivity to 81.8%. There was no correlation between the magnitude of bronchial response to exercise and UNDW (r_s = -0.03; p > 0.05). Exercise responders were not different from nonresponders in regard to gender, age, resting lung function, length of asthmatic history and treatment requirement to control symptoms. However, the UNDW responders were different from nonresponders in regard to age (p < 0.05) and length of asthmatic history (p < 0.001). Children younger than 9 years old are unlikely to show a bronchial response to UNDW inhalation, since only 9.5% of them developed a significant bronchoconstriction. We suggest that the two stimuli recognize some different pathways or subjects have basic biological differences.

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“…During a 2-year period (July 1978 to June 1980) we evaluated 166 patients with methacholine challenge. 10 These were clinical patients, rather than research subjects, whose histories suggested bronchial reactivity in the face of normal results of pulmonary function testing. Patients presented with one or more of the following: 1) history of wheezing or asthma without physical documentation, 2) history of chronic cough or recurrent bronchitis, or 3) history of frequent respiratory infections or other pulmonary problems sufficient to raise physician concern about reactive airways.…”

Section: Clinical Use Of Methacholine Challengementioning

confidence: 99%

Methacholine Bronchoprovocation Challenge in Children

Shapiro¹

1989

allergy asthma proc

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Methacholine bronchial challenge in children

Cited by 53 publications

References 9 publications

Effect of roxithromycin on airway responsiveness in children with bronchiectasis: a double-blind, placebo-controlled study

Effect of roxithromycin on airway responsiveness in children with bronchiectasis: a double-blind, placebo-controlled study

Airway Responsiveness to Exercise and Ultrasonically Nebulized Distilled Water in Children: Relationship to Clinical and Functional Characteristics

Methacholine Bronchoprovocation Challenge in Children

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