Diagnosing asthma in children: what is the role for methacholine bronchoprovocation testing?

Related Experiment Video

Updated: Jul 6, 2026

Murine Model of Allergen Induced Asthma
08:05

Murine Model of Allergen Induced Asthma

Published on: May 14, 2012

Joel J Liem1, Anita L Kozyrskyj, Donald W Cockroft

  • 1Section of Allergy and Clinical Immunology, Department of Pediatrics and Child Health, Manitoba Institute of Child Health, University of Manitoba, Manitoba, Canada.

Pediatric Pulmonology
|April 3, 2008
PubMed

Insights

Methacholine challenge is useful for diagnosing asthma in atopic children and nonatopic girls. However, it is not helpful for diagnosing asthma in nonatopic boys, emphasizing clinical context in pediatric asthma diagnosis.

Area of Science:

  • Pediatric Pulmonology
  • Allergy and Immunology
  • Diagnostic Medicine

Background:

  • Asthma diagnosis in children can be challenging.
  • Objective measures like methacholine challenge are explored to aid clinical assessment.

Purpose of the Study:

  • To evaluate the utility of methacholine-induced airway hyperresponsiveness for diagnosing asthma in pediatric populations.
  • To determine the diagnostic accuracy of methacholine challenge across different subgroups of children.

Main Methods:

  • A birth cohort of 640 children underwent asthma specialist assessment, skin testing, and methacholine challenge (PC20).
  • Children with doctor-diagnosed asthma and healthy controls were selected for analysis.
  • Sensitivity, specificity, and receiver operating curves were calculated for the methacholine challenge test.

Main Results:

  • Airway hyperresponsiveness showed moderate sensitivity and specificity for asthma diagnosis in girls (atopic and nonatopic).
  • The test was helpful for diagnosing asthma in atopic boys but not in nonatopic boys.
  • Specific PC20 thresholds were identified for different subgroups.

Conclusions:

  • Methacholine airway hyperresponsiveness is a valuable diagnostic aid for asthma in atopic children and nonatopic girls.
  • The test provides no diagnostic benefit for nonatopic boys with suspected asthma.
  • Findings underscore the importance of integrating laboratory results with clinical evaluation for accurate pediatric asthma diagnosis.
Abstract

More Related Videos

Assessment of Respiratory Function in Conscious Mice by Double-chamber Plethysmography08:58

Assessment of Respiratory Function in Conscious Mice by Double-chamber Plethysmography

Published on: July 10, 2018

Evaluation of Respiratory System Mechanics in Mice using the Forced Oscillation Technique13:10

Evaluation of Respiratory System Mechanics in Mice using the Forced Oscillation Technique

Published on: May 15, 2013

Related Concept Videos

Asthma-IV: Diagnostic and Management01:30

Asthma-IV: Diagnostic and Management

The diagnosis and management of asthma are comprehensive, encompassing clinical assessments, lung function tests, and pharmacological interventions. Here's an overview:
Clinical Assessment for Asthma:
This is the first step in diagnosing and managing asthma. It includes:
Asthma I: Introduction01:28

Asthma I: Introduction

Asthma is a chronic inflammatory disorder of the airways characterized by variable airflow obstruction and heightened bronchial responsiveness to a wide range of triggers. The underlying inflammation leads to airway swelling, mucus hypersecretion, and smooth muscle constriction, all of which narrow the airway lumen and impede airflow. Clinically, asthma presents with recurrent episodes of wheezing, shortness of breath, chest tightness, and coughing, symptoms that typically vary in intensity and...
Asthma: Pathogenesis and Management01:20

Asthma: Pathogenesis and Management

Asthma is a chronic pulmonary condition involving inflammation of the airways, hyper-reactivity, and reversible obstruction of the airways. This condition can significantly impact a person's quality of life, making breathing difficult and leading to distressing symptoms.
Asthma is classified as allergic and non-allergic. Allergens such as dust mites, pollen, and pet dander trigger allergic asthma, while factors like cold air, intense emotions, or exercise can induce non-allergic asthma.
Chronic Obstructive Pulmonary Disease-IV: Assessement and Diagnostic Studies01:27

Chronic Obstructive Pulmonary Disease-IV: Assessement and Diagnostic Studies

Assessing and diagnosing Chronic Obstructive Pulmonary Disease (COPD) involves a detailed approach that includes a comprehensive review of medical history, physical examination, and a variety of diagnostic tests. This thorough evaluation is essential to ensure an accurate diagnosis and guide effective management strategies.
Medical History
Asthma-I: Introduction01:29

Asthma-I: Introduction

Asthma is a chronic respiratory ailment that requires careful management due to its varying symptoms and influencing factors. It is characterized by airway inflammation, bronchial hyperresponsiveness, and reversible airflow obstruction, leading to symptoms like wheezing, shortness of breath, chest tightness, and coughing. The symptom frequency and intensity may vary considerably over time. It is also linked to immune system responses to allergens and irritants, highlighting the complex...
Asthma III: Clinical Manifestations01:13

Asthma III: Clinical Manifestations

Asthma presents with a characteristic pattern of episodic respiratory symptoms that reflect underlying airway inflammation, bronchoconstriction, and mucus hypersecretion. Although severity varies among individuals, certain clinical manifestations are considered hallmarks of the disorder and often guide diagnosis and assessment.Respiratory SymptomsA persistent cough is one of the most common early features of asthma. It is frequently dry and tends to worsen at night or in the early morning,...