Korean J Intern Med.  2018 Jul;33(4):807-814. 10.3904/kjim.2017.043.

Methacholine bronchial provocation test in patients with asthma: serial measurements and clinical significance

• Seo HJ
• Lee PH
• Kim BG
• Lee SH
• Park JS
• Lee J
• Park SW
• Kim DJ
• Park CS
• Jang AS

• KMID: 2416008
• DOI: http://doi.org/10.3904/kjim.2017.043

Abstract

BACKGROUND/AIMS
The methacholine bronchial provocation test (MBPT) is used to detect and quantify airway hyper-responsiveness (AHR). Since improvements in the severity of asthma are associated with improvements in AHR, clinical studies of asthma therapies routinely use the change of airway responsiveness as an objective outcome. The aim of this study was to assess the relationship between serial MBPT and clinical profiles in patients with asthma.
METHODS
A total of 323 asthma patients were included in this study. The MBPT was performed on all patients beginning at their initial diagnosis until asthma was considered controlled based on the Global Initiative for Asthma guidelines. A responder was defined by a decrease in AHR while all other patients were considered non-responders.
RESULTS
A total of 213 patients (66%) were responders, while 110 patients (34%) were non-responders. The responder group had a lower initial PC20 (provocative concentration of methacholine required to decrease the forced expiratory volume in 1 second by 20%) and longer duration compared to the non-responder group. Members of the responder group also had superior qualities of life, compared to members of the non-responder group. Whole blood cell counts were not related to differences in PC20; however, eosinophil concentration was. No differences in sex, age, body mass index, smoking history, serum immunoglobulin E, or frequency of acute exacerbation were observed between responders and non-responders.
CONCLUSIONS
The initial PC20, the duration of asthma, eosinophil concentrations, and quality-of-life may be useful variables to identify improvements in AHR in asthma patients.

Keyword

Airway hyper-responsiveness; Asthma; Methacholine bronchial provocation test

MeSH Terms

Asthma*
Blood Cell Count
Body Mass Index
Bronchial Provocation Tests*
Diagnosis
Eosinophils
Forced Expiratory Volume
Humans
Immunoglobulin E
Immunoglobulins
Methacholine Chloride*
Respiratory Hypersensitivity
Smoke
Smoking
Immunoglobulin E
Immunoglobulins
Methacholine Chloride
Smoke