Related Experiment Video
Updated: Aug 14, 2026
Murine Model of Allergen Induced Asthma
Published on: May 14, 2012
Metered-dose inhaler to deliver methacholine in bronchial provocation testing: a pilot study
N Roche1, F El Husseini, S Labrune
1Laboratoire de Biologie et Pharmacologie des Epithéliums Respiratoires, Université de Paris René Descartes, Boulogne, France.
Background:
Nonspecific bronchial provocation tests may be simplified by the use of hand-held devices to deliver methacholine.
Objective:
To study the feasibility of using a metered-dose inhaler (MDI) to administer methacholine in bronchial provocation tests, and the ability of such a device to diagnose bronchial hyperresponsiveness (BHR) accurately.
Methods:
In an open randomized crossover pilot study, we compared the provocative dose that induces a 20% fall in FEV1 (PD20 FEV1) obtained with the methacholine MDI with that obtained using a conventional nebulizer in 20 hyperresponsive and 20 nonhyperresponsive subjects. The MDI delivers 400 doses of 100 microg of methacholine, and was used via a spacer. Bronchial hyperresponsiveness (BHR) was defined as a PD20 FEV1 <2,000 microg with the conventional test using the nebulizer. The tests were performed in each subject in a randomized order, 1 to 7 days apart.
Results:
Of the subjects who had a nebulizer PD20 FEV1 <2,000 microg, all but one had an MDI PD20 FEV1 <800 microg. When 800 microg was taken as the threshold for the diagnosis of BHR with the MDI test, the accuracy of this test to diagnose BHR was 97.5%, and the two tests were highly concordant for the diagnosis of BHR (Pearson chi2, 36.19; p<0.0001).
Conclusion:
A hand-held device may be suitable for delivery of methacholine during bronchial provocation tests, if these results are confirmed in large samples.
