Comparison of Isocapnic Hyperventilation and Histamine or Methacholine Inhalation for the Assessment of Airway Responsiveness

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Several stimuli have been used to evaluate the degree of airway hyperresponsiveness in asthma. Each of these has possible advantages and disadvantages when compared to the other methods. The most widely used involves the inhalation of chemical bronchoconstrictors, most commonly histamine or methacholine. This paper contrasts these inhalation tests with airway challenges using isocapnic hyperventilation of dry air. Isocapnic hyperventilation uses a naturally occurring stimulus to provoke bronchoconstriction rather than a chemical stimulus and can be administered in a dose-response fashion. Therefore, isocapnic hyperventilation may be particularly useful in epidemiologic surveys. The maximal dose administered, however, is determined by the level of a subject's maximal voluntary ventilation; also the equipment needed to administer the challenge is relatively complex when compared to other methods. By contrast, histamine and methacholine inhalation tests require simple, inexpensive equipment and can be inhaled at high concentrations, which means that airway responsiveness can be measured even in many nonasthmatic subjects. However, at high inhaled concentrations, histamine has many more systemic side effects than methacholine. Once the factors known to influence the measurements of airway responsiveness are controlled, the measurements made with one method correlate well with all other methods. Therefore, the method chosen will often depend on the requirements of the study or clinical laboratory.

Document Type: Research Article


Publication date: September 1, 1989

More about this publication?
  • Allergy and Asthma Proceedings is a peer reviewed publication dedicated to distributing timely scientific research regarding advancements in the knowledge and practice of allergy, asthma and immunology. Its primary readership consists of allergists and pulmonologists.

    The goal of the Proceedings is to publish articles with a predominantly clinical focus which directly impact quality of care for patients with allergic disease and asthma.

    Featured topics include asthma, rhinitis, sinusitis, food allergies, allergic skin diseases, diagnostic techniques, allergens, and treatment modalities. Published material includes peer-reviewed original research, clinical trials and review articles.

    Articles marked "F" offer free full text for personal noncommercial use only.

    The journal is indexed in Thomson Reuters Web of Science and Science Citation Index Expanded, plus the National Library of Medicine's PubMed service.
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