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Journals / Toraks Dergisi / 2008 / Cilt: 9 - Sayı: 1

Bronchial provocation test using AMP and methacholine in subjects with asthma and COPD, healthy smokers and non-smokers

Astım ve KOAH olguları ile sigara içen ve içmeyen sağlıklılarda AMP ve metakolin ile bronş provokasyon testi

Aslı TOROS
Zeynep Ayfer SOLAK
Münevver ERDİNÇ
Ali KOKULUDAĞ
Pages
22–26
DOI
—
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AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

Provocation test using AMP is more sen- sitive than methacholine in the differentiating diagnosis of airway inflamma- tion in asthma and COPD and being a current smoker may increase inflam- mation, and thus the AMP responsiveness in COPD.

📌 3 Key Takeaways

🎯
Objective & Hypothesis:A direct stimulus such as methacholine is generally used to measure bronchial hyperresponsiveness.
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Key Findings & Data:The study population consists of 60 sub- jects including 16 with mild asthma, 14 with mild-moderate COPD (8 current smokers and 6 ex-smokers), 15 non-smokers, and 15 current smokers.
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Conclusion & Impact:Provocation test using AMP is more sen- sitive than methacholine in the differentiating diagnosis of airway inflamma- tion in asthma and COPD and being a current smoker may increase inflam- mation, and thus the AMP responsiveness in COPD.
🔬Design:Research Article
📍Scope:Comprehensive Sample
⚙️Variables:Bronşiyal hiperreaktivite · Adenozin monofosfat · Astım

Abstract

A direct stimulus such as methacholine is generally used to measure bronchial hyperresponsiveness. AMP, an indirect airway challenge, has been reported to be a better marker of inflammation than direct challenges and can be used in the differential diagnosis of asthma from other airway diseases. In this study, the effects of bronchial provocation test (BPT) using AMP and methacholine were compared in patients with asthma and COPD as well as healthy smokers and non-smokers. The study population consists of 60 sub- jects including 16 with mild asthma, 14 with mild-moderate COPD (8 current smokers and 6 ex-smokers), 15 non-smokers, and 15 current smokers. All the subjects underwent BPT using AMP and methacholine. 14 (87.5%) patients with asthma and seven (50%) patients with COPD were AMP responsive at a concentration of PC20≤100mg/ml (p=0.046). When asthmatic patients and current smokers with COPD were compared to each other, no significant difference was found related toAMP and methacholine respon- siveness. However, one (16.7%) ex-smoker with COPD and 14 (87.5%) patients with asthma were AMP responsive at a concentration of PC20≤100mg/ml (p=0.004). Re-evaluated at an AMP concentration of PC20≤800mg/ml, 15 asth- matics (93.8%) and two ex-smokers with COPD (33.3%) were assessed to be hyperresponsiveness to AMP (p=0.009). Patients with COPD were more responsive to the maximal concentration of both AMP and methacholine than healthy smokers (p=0.008, p=0.009). Provocation test using AMP is more sen- sitive than methacholine in the differentiating diagnosis of airway inflamma- tion in asthma and COPD and being a current smoker may increase inflam- mation, and thus the AMP responsiveness in COPD.

Özet

Bronş hiperreaktivitesinin saptanmasında genellikle metakolin gibi direkt uyarıcı bir madde kullanılmaktadır. İndirekt uyaran olan AMP'nin direkt uyaranlardan daha iyi bir inflamasyon belirleyicisi olduğu bildirilmektedir ve astımın diğer hava yolu hastalıklarından ayırıcı tanısında kullanılabilir. Bu çalışmada astım ve KOAH olguları ile sağlıklı sigara içen ve içmeyen olgularda metakolin ve AMP ile yapılan bronş provokasyon testinin (BPT) etkileri karşılaştırılmıştır. Çalışmaya 16 hafif astım, 14 hafif-orta KOAH (sigara içen 8, sigarayı bırakmış 6 olgu), 15 sigara içen, 15 sigara içmeyen olmak üzere 60 olgu alınmıştır. Tümüne metakolin ve AMP ile BPT yapılmıştır. AMP'ın PC20<100mg/ml konsantrasyonunda astım olgularının 14'ü (%87.5), KOAH olgularının 7'si (%50) duyarlı bulunmuştur (p=0.046). Astım olguları ile sigara içmeye devam eden KOAH olguları arasında AMP ya da metakoline karşı hava yolu duyarlılığı açısından farklılık yoktur. Buna karşılık sigarayı bırakmış KOAH olgularının biri (%16.7), astım olgularının ise 14'ü (%87.5) AMP'ye PC20<100mg/ml konsantrasyonda duyarlı bulunmuştur (p=0.004). PC20£800mg/ml AMP konsantrasyonunda 15 (%93.8) astım, 2 (%33.3) sigarayı bırakmış KOAH olgusunda hava yolu duyarlılığı vardır (p=0.009). KOAH olguları, sigara içen sağlıklılara göre AMP ve metakoline karşı daha duyarlıdırlar (p=0.008, p=0.009). AMP ile yapılan provokasyon testi, astım ve KOAH'daki hava yolu inflamasyonunun ayırıcı tanısında metakolinden daha duyarlıdır ve sigara içmeyi sürdürmek, KOAH olgularında enflamasyonu, dolayısıyla AMP duyarlılığını artırabilir.

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Cite This Article

TOROS, A., SOLAK, Z. A., ERDİNÇ, M., KOKULUDAĞ, A. (2008). Bronchial provocation test using AMP and methacholine in subjects with asthma and COPD, healthy smokers and non-smokers. Toraks Dergisi, Cilt: 9 - Sayı: 1, 22–26. https://ajindex.com/articles/368150

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