Allergy Asthma Respir Dis.
2024 Jul;12(3):140-146. 10.4168/aard.2024.12.3.140.
Comparison of 3 protocols in the methacholine bronchial provocation test
- Affiliations
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- 1Division of Pulmonology and Allergy, Department of Internal Medicine, Gachon University Gil Medical Center, Gachon University College of Medicine, Incheon, Korea
- 2Department of Internal Medicine, Gachon University Gil Medical Center, Gachon University College of Medicine, Incheon, Korea
- 3Division of Respiratory Diseases and Allergy, Department of Internal Medicine, Dankook University College of Medicine, Cheonan, Korea
- 4Division of Allergy and Clinical Immunology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
- 5Department of Allergy and Clinical Immunology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
- KMID: 2558373
- DOI: http://doi.org/10.4168/aard.2024.12.3.140
Abstract
- Purpose
In Korea, KoKo dosimetry and Aerosol Provocation System (APS) are used in the methacholine provocation test (MBPT). In this study, three protocols of the MBPT were compared.
Methods
In patients showing a positive MBPT using short 2-concentration methods for APS with cumulative provocative doses of methacholine which results in a 20% fall in forced expiratory volume in 1 second (FEV 1) (PD20) ≤ 962.81, the MBPT was repeated, using 14-breaths methods for APS. In them, PD20 of those 2 protocols were compared to each other. Provocative concentration of methacholine which results in a 20% fall in FEV 1 (PC20) in 14-breaths methods was also compared with that of 5-breaths methods in other patients showing a positive MBPT with KoKo dosimettry during the study period.
Results
The positive rate in short 2-concentration methods was 18.1% (43 of 238), while that in 5-breaths methods was 14.0% (6 of 43). They were not different from each other (P= 0.342). In 7 patients who underwent the MBPT twice, using short 2-concentration and subsequent 14-breaths methods. The median of PD20 with a positive MBPT using short 2-concentration methods was 573.8 μg with interquartile range (IQR) of 147.8–682.3 μg, whereas that in repeated MBPT using 14-breaths methods was 526.4 μg (IQR, 95.0– 907.1 μg). They did not differ from each other (P= 0.735). The median of PC20 in MBPT using 14-breaths methods was 4.76 mg/mL (IQR, 0.066–10.3 mg/mL) tended to be higher than that in other 6 patients who showed a positive MBPT using 5-breaths methods, 1.95 mg/mL (IQR, 0.42–4.85 mg/mL), but it was not significant (P = 0.534).
Conclusion
Bronchial hyperresponsiveness was not different in 3 protocols of MBPT.
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