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Bronchoprovocation methods

Direct challenges

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Abstract

Inhalation challenges with direct-acting stimuli histamine and methacholine are widely used to measure airway responsiveness. Three widely used methods (2-min tidal breathing method, breath-activated dosimeter method, hand-held manual nebulizer) are described. Careful standardization is important so as to best differentiate normal from increased airway responsiveness and to permit comparison between methods. With current methods standardized as suggested by the ATS, a methacholine (or histamine) PC20>16 mg/mL is considered normal. APC20<16 mg/mL is highly sensitive for current symptoms of asthma. Interpretation of methacholine or histamine inhalation test requires that symptoms be current (within a few days) and that FEV1 be normal.

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  1. Department of Medicine, Division of Respiratory Medicine, Royal University Hospital, S7N 0W8, Saskatoon, SK, Canada

    Donald W. Cockcroft

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  1. Donald W. Cockcroft
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Cockcroft, D.W. Bronchoprovocation methods. Clinic Rev Allerg Immunol 24, 19–26 (2003). https://doi.org/10.1385/CRIAI:24:1:19

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