Does The Methacholine Test Reproduce Symptoms?

2010 ◽  
Author(s):  
Jean-Luc Malo ◽  
Marianne Lévesque ◽  
Heberto Ghezzo
Keyword(s):  
Methacholine Test

scholarly journals Correlation between Reduced FEF25-75% and a Positive Methacholine Challenge Test in Adults with Nonobstructive Baseline Spirometry

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Irfan Shafiq ◽  
Mateen Haider Uzbeck ◽  
Zaid Zoumot ◽  
Mohamed Abuzakouk ◽  
Niyas Parappurath ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Challenge Test ◽  
Methacholine Challenge ◽  
Methacholine Challenge Test ◽  
Children With Asthma ◽  
Methacholine Test ◽  
Log Odds ◽  
Baseline Characteristics ◽  
And Gender ◽  
Small Airway Obstruction

Rationale. FEF25-75% is routinely reported on spirometry and is thought to be a marker of small airway obstruction. It is reduced in children with asthma, but its significance in adults and especially those without asthma diagnosis remains unclear. Objective. To clarify whether in adults with a nonobstructive spirometry a reduced FEF25-75% is associated with a positive methacholine challenge test (MCT). Methods. Data was collected for all the patients who had a MCT done between April 2014 and January 2020 but had nonobstructive baseline spirometry. Logistic regression was utilized to estimate the log odds of a positive methacholine test as a function of FEF25-75% and also for age, gender, BMI, FEV1, and FEV1/FVC. Results. Out of 496 patients, 187 (38%) had a positive MCT. Baseline characteristics in two groups were similar except that patients with positive MCT were younger ( 32 ± 11.57 vs. 38 ± 13.25 years, respectively, p < 0.001 ). Mean FEF25-75% was lower in MCT positive ( 3.12 ± 0.99  L/s) vs. MCT negative ( 3.39 ± 0.97  L/s) patients, p = 0.003 . Logistic regression results suggest that MCT outcome is inversely related to FEF25-75%, age, and gender. Specifically, as FEF25-75% percentage of predicted value increases, the log odds of a positive MCT decrease ( odds   ratio   OR = 0.90 , 95% confidence intervals   CI = 0.84 ‐ 0.96 , p = 0.002 ). Also, as age increases, the log odds of a positive MCT decrease ( OR = 0.95 , 95 % CI = 0.94 ‐ 0.97 , p < 0.001 ). Conclusions. Reduced FEF25-75% in adults with nonobstructive spirometry can predict a positive response to MCT in younger patients. However, this relationship becomes weaker with increasing age.

scholarly journals Characteristics of Atopic Bronchial Asthma in Seniors over 80 Years of Age

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Andrzej Bożek ◽  
Marek Filipowski ◽  
Andreas Fischer ◽  
Jerzy Jarzab
Keyword(s):  
Age Groups ◽  
Public Health Problem ◽  
The Elderly ◽  
Diagnostic Methods ◽  
House Dust Mites ◽  
Life Questionnaire ◽  
Important Public Health Problem ◽  
Atopic Bronchial Asthma ◽  
Methacholine Test ◽  
Elderly Asthmatics

Background. Asthma in the elderly is an important public health problem. The aim of this study was to assess the prevalence and characteristics of asthma in seniors.Materials and Methods. The study involved 105 people of at least 80 years of age (mean age of 84.1 ± 3.9 years) selected from a group of 1860 individuals. Spirometry, the methacholine test, allergy diagnosis, a measurement of exhaled nitric oxide, and administration of the asthma quality of life questionnaire (AQLQ) were performed.Results. The average morbidity of asthma in the study population of elderly people (at least 80 years of age) was 5.6% (105 people) of the confidence interval (95% CI: 5.1–6.0). In the study group, 34% of the elderly asthmatics had uncontrolled asthma, 47% had partly controlled asthma, and only 24% had fully controlled asthma. Allergy to house dust mites was predominant. The average total score on the AQLQ was 4.12 ± 0.72 (arithmetic mean ± standard deviation) for the seniors, which was significantly lower than the score for the young.Conclusion. The pathogenesis, natural history, and value of the basic diagnostic methods of asthma in the elderly are similar to those observed in younger age groups.

scholarly journals Does the Methacholine Test Reproduce Symptoms?

2010 ◽  
Vol 17 (5) ◽  
pp. 224-228 ◽  
Author(s):  
Marianne Lévesque ◽  
Heberto Ghezzo ◽  
Jocelyne L’Archevêque ◽  
Jean-Luc Malo
Keyword(s):  
Positive Predictive Value ◽  
Predictive Value ◽  
Daily Life ◽  
Forced Expiratory Volume ◽  
Test Results ◽  
Chest Tightness ◽  
Specific Symptom ◽  
Predictive Values ◽  
Methacholine Test ◽  
Young Subjects

BACKGROUND: The interpretation of methacholine test results do not usually consider the symptoms for which the subject was referred and those that occur during the test.OBJECTIVE: To assess the association between methacholine test results and symptoms, and to examine variables that may affect this association.METHODS: A total of 400 prospectively chosen subjects who underwent methacholine testing for possible asthma were investigated. The subjects answered a short questionnaire regarding the symptoms for which they had been referred and those that were encountered during the methacholine test.RESULTS: The positive predictive value for the reproduction of symptoms during the test compared with symptoms for which subjects had been referred were 84% for dyspnea, 87% for cough, 81% for wheezing and 72% for chest tightness. The positive predictive value among the values obtained by measuring the provocative concentration of methacholine causing a 20% fall (PC20) in forced expiratory volume in 1 s on the one hand, and specific symptoms on the other, varied by up to approximately 50%; negative predictive values were higher. Forty-eight per cent of subjects with a PC20of 16 mg/mL or lower reported that the test had globally reproduced their symptoms. This association was significantly stronger in women, young subjects and those taking inhaled steroids.CONCLUSIONS: The methacholine test generally reproduced the symptoms for which the subjects were referred. The absence of a specific symptom (eg, dyspnea, cough, wheezing or chest tightness), either in daily life or at the time of methacholine testing, was more generally associated with a negative test than the reverse. The global impression that the test had reproduced what the patient had experienced in daily life was significantly associated with a positive test (ie, a PC20of 16 mg/mL or lower), with the association being stronger in young subjects and women.

Tachyphylaxis to inhaled methacholine in normal but not asthmatic subjects

1990 ◽  
Vol 69 (3) ◽  
pp. 875-879 ◽  
Author(s):  
W. H. Stevens ◽  
P. J. Manning ◽  
R. M. Watson ◽  
P. M. O'Byrne
Keyword(s):  
Time Course ◽  
Normal Subjects ◽  
Forced Expiratory Volume ◽  
Airway Responsiveness ◽  
Cyclooxygenase Inhibitors ◽  
Test Results ◽  
Methacholine Test ◽  
Series Of Experiments ◽  
The Mean

Methacholine inhalation tests measure airway responsiveness in asthmatic and normal subjects. Tachyphylaxis occurs with repeated methacholine inhalations in normal subjects. The purpose of this study was to examine the time course and mechanisms of methacholine tachyphylaxis in normal subjects and to determine whether this occurs in mildly asthmatic subjects. Fifteen normal and nine asthmatic subjects were studied on 2 study days, at least 48 h apart. Each day, two inhalation tests were carried out. On one day, subjects performed two methacholine inhalation tests 3 h later by a methacholine test. Results were expressed as the provocation concentration causing a 20% fall in forced expiratory volume in 1 s (FEV1), (PC20). All normal subjects developed methacholine tachyphylaxis. The mean PC20 increased from 47.3 mg/ml (%SE 1.34) to 115.6 (%SE 1.51) (P less than 0.0001) in a 3-h interval. This increase lasted for greater than or equal to 6 h (P = 0.012). Asthmatic subjects did not develop methacholine tachyphylaxis. Their mean methacholine PC20s were 1.6 mg/ml (%SE 1.4) and 1.5 (%SE 1.4) (P = 0.75) 3 h later. In two other series of experiments, normal subjects were pretreated with the cyclooxygenase inhibitors indomethacin (100 mg/day) or flurbiprofen (150 mg/day) or a placebo for 3 days before two methacholine tests 3 h apart. Both indomethacin and flurbiprofen significantly inhibited the development of methacholine tachyphylaxis. These results confirm that methacholine tachyphylaxis occurs in normal subjects, lasts greater than or equal to 6 h, and may occur through the release of inhibitory prostaglandins. By contrast, methacholine tachyphylaxis does not occur in asthmatic subjects.

scholarly journals Obesity can influence children’s and adolescents’ airway hyperresponsiveness differently

2013 ◽  
Vol 8 ◽  
Author(s):  
Bruno Sposato ◽  
Marco Scalese ◽  
Maria Giovanna Migliorini ◽  
Maria Piera Riccardi ◽  
Massimo Tosti Balducci ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Risk Factor ◽  
Lung Function ◽  
Airway Hyperresponsiveness ◽  
Normal Weight ◽  
Obese Children ◽  
Male Adolescents ◽  
Asthma Symptoms ◽  
Methacholine Test ◽  
Obese Subjects

Background: Literature is still arguing about a possible relationship between airway hyperresponsiveness (AHR) and body mass index (BMI). This study aimed at evaluating the influence of BMI on AHR and pulmonary function in children and adolescents that performed a methacholine test for suggestive asthma symptoms. Methods: 799 consecutive children/adolescents (535 M; mean age: 15 ± 3 yrs; median FEV1% predicted: 101.94% [93.46-111.95] and FEV1/FVC predicted: 91.07 [86.17-95.38]), were considered and divided into underweight, normal, overweight and obese. Different AHR levels were considered as moderate/severe (PD20 ≤ 400 μg) and borderline (PD20 > 400 μg). Results: 536 children/adolescents resulted hyperreactive with a median PD20 of 366 μg [IQR:168–1010.5]; 317 patients were affected by moderate/severe AHR, whereas 219 showed borderline hyperresponsiveness. Obese subjects aged > 13 years showed a lower (p = 0.026) median PD20 (187μg [IQR:110–519]) compared to overweight (377 μg [IQR:204–774]) and normal-weight individuals’ values (370.5 μg [IQR:189–877]). On the contrary, median PD20 observed in obese children aged ≤ 13 years (761 μg [IQR:731–1212]) was higher (p = 0.052) compared to normal-weight children’s PD20 (193 μg [IQR:81–542]) and to obese adolescents’ values (aged > 13 years) (p = 0.019). Obesity was a significant AHR risk factor (OR:2.853[1.037-7.855]; p = 0.042) in moderate/severe AHR adolescents. Females showed a higher AHR risk (OR:1.696[1.046-2.751] p = 0.032) compared to males. A significant relationship was found between BMI and functional parameters (FEV1, FVC, FEV1/FVC) only in hyperreactive females. Conclusions: Obesity seems to influence AHR negatively in female but not in male adolescents and children. In fact, AHR is higher in obese teenagers, in particular in those with moderate/severe hyperresponsiveness, and may be mediated by obesity-associated changes in baseline lung function.

Sign in / Sign up

Export Citation Format

Share Document