Related Experiment Video
Updated: Aug 17, 2026
Testing Acetylcholine Followed by Adenosine for Invasive Diagnosis of Coronary Vasomotor Disorders
Published on: February 3, 2021
Evaluation of an abbreviated adenosine monophosphate bronchial challenge
Tom C Fardon1, Melissa R Hodge, Brian J Lipworth
1Asthma and Allergy Research Group, University of Dundee, Ninewells Hospital and Medical School, Dundee, DD1 9SY, UK.
Rationale:
Airway hyperresponsiveness to adenosine monophosphate (AMP) has been validated as a surrogate marker for airway inflammation. We wished to know whether an abbreviated challenge at the final threshold dose would produce the same fall in FEV1 as a full, conventional dose-response challenge.
Methods:
Seventeen patients with mild-to-moderate asthma (mean FEV1, 75.5% predicted) attended for a full dose-response protocol, where the highest concentration of AMP to produce > 20% fall in FEV1 was noted, along with the maximum percentage fall and recovery time. Patients returned within 2 days for a further challenge, when they received only the highest concentration (as a single bolus) reached on the previous visit.
Results:
The mean (+/- SEM) percentage fall in FEV1 after the full challenge was 25.5 +/- 1.3%, and after the abbreviated challenge was 9.4 +/- 2.4%. The mean recovery after the full challenge was 28.13 +/- 4.65 min, and after the abbreviated test was 10.81 +/- 4.27 min.
Conclusion:
An abbreviated challenge using a single bolus dose of AMP grossly underestimates bronchial hyperresponsiveness. Although the pharmacologic half-life of AMP is short (90 s), the lesser response and shortened recovery with the abbreviated challenge suggest a more prolonged physiologic half-life, which in turn may have implications for abbreviated challenge protocols.
Insights
An abbreviated adenosine monophosphate (AMP) challenge test underestimates bronchial hyperresponsiveness compared to a full dose-response test. This suggests a longer physiological effect than its short pharmacological half-life implies.
Area of Science:
- Pulmonary Medicine
- Respiratory Physiology
Background:
- Airway hyperresponsiveness to adenosine monophosphate (AMP) is a validated marker for airway inflammation.
- Conventional dose-response challenges are used to assess this hyperresponsiveness.
Purpose of the Study:
- To determine if an abbreviated AMP challenge at the threshold dose replicates the FEV1 fall of a full dose-response challenge.
- To investigate the implications of abbreviated challenge protocols for assessing bronchial hyperresponsiveness.
Main Methods:
- Seventeen patients with mild-to-moderate asthma underwent a full AMP dose-response challenge to identify the threshold dose.
- A subsequent abbreviated challenge administered only the threshold AMP concentration as a single bolus.
Main Results:
- The full challenge resulted in a mean FEV1 fall of 25.5%, while the abbreviated challenge caused a 9.4% fall.
- Mean recovery time was 28.13 minutes after the full challenge and 10.81 minutes after the abbreviated challenge.
Conclusions:
- An abbreviated AMP challenge significantly underestimates bronchial hyperresponsiveness.
- The prolonged physiological effect, despite AMP's short pharmacological half-life, has implications for abbreviated challenge test design.
Related Concept Videos
01:27Chronic Obstructive Pulmonary Disease-IV: Assessement and Diagnostic Studies
Medical History
01:23Assessment of Respiration
Subjective Assessment: Nurses interview the patient to gather information directly during the subjective assessment. It includes questions about the individual's medical history, medications, and symptoms, focusing on past respiratory conditions like asthma or COPD,...