Document Detail


Airway hyperresponsiveness: a comparative study of methacholine and exercise challenges in seasonal allergic rhinitis with or without asthma.
MedLine Citation:
PMID:  19544170     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Asymptomatic airway hyperreactivity in allergic rhinitis is a risk factor for later development of asthma. Although non-specific bronchial hyperresponsiveness (BHR) has been measured by several stimuli, the most appropriate measurement technique still remains unclear. OBJECTIVE: To investigate whether an exercise challenge can be used to predict BHR in seasonal allergic rhinitis patients with or without asthma and to compare this bronchial reactivity with a methacholine challenge technique. METHODS: Forty-six consecutive patients with seasonal allergic rhinitis only (n = 31) and with both seasonal allergic rhinitis and asthma (n = 15) were included in the study during the pollination period. Subjects underwent first methacholine (mch) and then exercise challenge testing (ECT). There was a 1-week interval between the tests. ECT was performed on a bicycle ergometer. Positive result was defined as a 15% decrease in forced expiratory volume in 1 second (FEV(1)) post-exercise. A patient's bronchial reactivity to methacholine was considered as hyperresponsive if PC(20) was less than 8 mg/mL. RESULTS: Mch PC(20) values were significantly lower in patients with both rhinitis and asthma (p < 0.062). Among the 46 patients, mch PC(20) values were significantly different between patients who had positive and negative exercise challenge tests (p = 0.007). All patients with rhinitis alone had a negative ECT and 10 had a positive mch challenge. Change in FEV(1) values after ECT was significantly higher in patients with both rhinitis and asthma compared to those with rhinitis alone (p = 0.009). There was a significant relation between positivity of mch and exercise challenges (p = 0.025). ECT positivity was found to be a significant confounding factor in the diagnosis of asthma (p = 0.001). Specificity and sensitivity values were 100% and 24% for ECT and 68% and 100% for mch, respectively. CONCLUSION: Exercise challenge presents poor diagnostic value for detecting bronchial responsiveness in individuals with allergic rhinitis alone during the pollen season.
Authors:
Betül Ayse Sin; Oznur Akkoca Yildiz; Adile Berna Dursun; Zeynep Misirligil; Yavuz Selim Demirel
Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  The Journal of asthma : official journal of the Association for the Care of Asthma     Volume:  46     ISSN:  1532-4303     ISO Abbreviation:  J Asthma     Publication Date:  2009 Jun 
Date Detail:
Created Date:  2009-06-22     Completed Date:  2009-07-15     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8106454     Medline TA:  J Asthma     Country:  England    
Other Details:
Languages:  eng     Pagination:  486-91     Citation Subset:  IM    
Affiliation:
School of Medicine, Division of Allergic Diseases, Ankara University, Dikimevi, 06100-Ankara, Turkey. bsin@medicine.ankara.edu.tr
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MeSH Terms
Descriptor/Qualifier:
Adult
Asthma / complications,  physiopathology*
Bronchial Hyperreactivity / diagnosis*,  etiology
Exercise Test*
Female
Humans
Male
Methacholine Chloride / diagnostic use*
Respiratory Function Tests
Rhinitis, Allergic, Seasonal / complications,  diagnosis,  physiopathology*
Skin Tests
Chemical
Reg. No./Substance:
62-51-1/Methacholine Chloride

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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