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Related Experiment Videos

Bronchoprovocation methods: direct challenges.

Donald W Cockcroft1

  • 1Department of Medicine, Royal University Hospital, Saskatoon, Canada. cockcroft@sask.usask.ca

Clinical Reviews in Allergy & Immunology
|March 20, 2003
PubMed
Summary
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Airway responsiveness tests using histamine and methacholine are crucial for diagnosing asthma. Standardization ensures accurate results, with a PC(20) less than 16 mg/mL indicating high sensitivity for current asthma symptoms.

Area of Science:

  • Pulmonary Medicine
  • Respiratory Physiology

Background:

  • Airway hyperresponsiveness is a hallmark of asthma.
  • Histamine and methacholine inhalation challenges are standard diagnostic tools.
  • Several methods exist for administering these challenges, requiring careful standardization.

Purpose of the Study:

  • To describe and compare three common methods for airway responsiveness testing.
  • To emphasize the importance of standardization in these tests.
  • To clarify the interpretation of results for diagnosing asthma.

Main Methods:

  • Description of three inhalation challenge methods: 2-min tidal breathing, breath-activated dosimeter, and hand-held manual nebulizer.
  • Emphasis on standardization protocols, referencing ATS guidelines.

Related Experiment Videos

  • Measurement of provocative concentration 20 (PC20) for methacholine or histamine.

    • Main Results:

    • A methacholine (or histamine) PC20 > 16 mg/mL is considered normal under standardized ATS conditions.
    • A PC20 < 16 mg/mL is highly sensitive for detecting current asthma symptoms.
    • Accurate interpretation requires current symptoms and a normal FEV1.

    Conclusions:

    • Standardized inhalation challenge testing with histamine or methacholine is essential for accurate airway responsiveness assessment.
    • The PC20 threshold of 16 mg/mL effectively identifies individuals with current asthma symptoms.
    • Proper interpretation necessitates considering symptom recency and baseline lung function (FEV1).