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Related Experiment Videos

Testing airway responsiveness using inhaled methacholine or histamine

A James1, G Ryan

  • 1Department of Pulmonary Physiology, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia.

Respirology (Carlton, Vic.)
|June 1, 1997
PubMed
Summary

Airway responsiveness testing using histamine or methacholine is safe and reproducible in adults and children. While useful for diagnosing asthma, its predictive value is moderate, especially in excluding the condition.

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Area of Science:

  • Pulmonary Medicine
  • Respiratory Physiology
  • Diagnostic Testing

Background:

  • Airway responsiveness testing, using agents like histamine and methacholine, is a well-established clinical and research tool.
  • The safety, reproducibility, and ease of administration in both adults and children are key advantages.
  • Methacholine is generally better tolerated than histamine, yielding similar results.

Purpose of the Study:

  • To evaluate the diagnostic utility of airway responsiveness measurements in identifying asthma.
  • To assess the reproducibility and influencing factors of airway responsiveness tests.
  • To determine the value of these tests in various clinical and research settings.

Main Methods:

  • Assessment of airway responsiveness using provocative agents like histamine and methacholine.

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  • Measurement of the provocative dose causing a 20% fall in forced expiratory volume in 1 second (PD20FEV1) or the dose-response slope (DRS).
  • Analysis of test reproducibility under controlled technical factors, typically within one to two doubling doses.

    • Main Results:

    • Airway responsiveness is increased in children, the elderly, and women compared to men.
    • Baseline lung function and smoking status can influence test interpretation.
    • At a PD20 cutoff of 8 mg/mL, tests show approximately 60% sensitivity and 90% specificity for asthma diagnosis.

    Conclusions:

    • Airway responsiveness testing is a valuable tool but has limitations in definitively diagnosing asthma due to the lack of a gold standard.
    • The tests are of intermediate value for predicting asthma in clinical settings with non-specific symptoms and less useful for exclusion.
    • These tests are useful in occupational asthma assessment, research for excluding asthma, and as objective markers in population studies.