Nonspecific Bronchoprovocation Test

Abstract

Bronchial asthma is a disease characterized by the condition of airway hyper-responsiveness, which serves to produce narrowing of the airway secondary to airway inflammation and/or various spasm-inducing stimulus. Nonspecific bronchoprovocation testing is an important method implemented for the purpose of diagnosing asthma; this test measures the actual degree of airway hyper-responsiveness and utilizes direct and indirect bronchoprovocation testing. Direct bronchoprovocation testing using methacholine or histamine may have superior sensitivity as these substances directly stimulate the airway smooth muscle cells. On the other hand, this method also engenders the specific disadvantage of relatively low specificity. Indirect bronchoprovocation testing using mannitol, exercise, hypertonic saline, adenosine and hyperventilation serves to produce reactions in the airway smooth muscle cells by liberating mediators with stimulation of airway inflammatory cells. Therefore, this method has the advantage of high specificity and also demonstrates relatively low sensitivity. Direct and indirect testing both call for very precise descriptions of very specific measurement conditions. In addition, it has become evident that challenge testing utilizing each of the various bronchoconstrictor stimuli requires distinct and specific protocols. It is therefore important that the clinician understand the mechanism by which the most commonly used bronchoprovocation testing works. It is important that the clinician understand the mechanism of action in the testing, whether direct stimuli (methacholine) or indirect stimuli (mannitol, exercise) is implemented, when the testing is performed and the results interpreted.

Can bronchial challenge test with adenosine or methacholine at preschool age predict school‐age asthma?

“…Based on the clinical question, we decided to perform BCT with adenosine, mainly to prove the diagnosis of asthma when positive and in atopic children to rule it out when negative. Methacholine‐BCT was chosen, primarily to determine the severity of the AHR present at the time of the study or to rule out any current hyperreactive‐airway disease when negative 15 . The institutional review board at Wolfson Medical Center approved this study.…”

Short-term exposure to stone minerals used in asphalt affect lung function and promote pulmonary inflammation among healthy adults

“…Airway hyperreactivity (AHR) results from inflammatory reactions in the airway. AHR can be measured by various means, such as the methacholine challenge test, in which airway smooth muscle muscarinic receptors are activated to induce bronchoconstriction (8,9).…”

Role of pulmonary function testing in inflammatory bowel diseases (Review)

“…The provocative dose (PD20) or concentration (PC20), which results in a 20% decrease in FEV1 in a positive test, is recorded. This test is used to aid with the diagnosis of asthma (45)(46)(47).…”

“…Additionally, FRC has been found to be greater in patients with IBDs compared with healthy controls and during the exacerbation of the IBDs than during the remission phase ( 24 ). Elevated lung volumes in patients with IBD may represent bronchial or bronchiolar inflammation, and an increase in RV/TLC may be a useful tool for investigating lung involvement in these patients ( 45 ).…”