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    ERS technical standard on bronchial challenge testing: pathophysiology and methodology of indirect airway challenge testing

    Access Status
    Fulltext not available
    Authors
    Hallstrand, T.
    Leuppi, J.
    Joos, G.
    Hall, Graham
    Carlsen, K.
    Kaminsky, D.
    Coates, A.
    Cockcroft, D.
    Culver, B.
    Diamant, Z.
    Gauvreau, G.
    Horvath, I.
    de Jongh, F.
    Laube, B.
    Sterk, P.
    Wanger, J.
    Date
    2018
    Type
    Journal Article
    
    Metadata
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    Citation
    Hallstrand, T. and Leuppi, J. and Joos, G. and Hall, G. and Carlsen, K. and Kaminsky, D. and Coates, A. et al. 2018. ERS technical standard on bronchial challenge testing: pathophysiology and methodology of indirect airway challenge testing. The European respiratory journal. 52 (5): 1801033.
    Source Title
    The European respiratory journal
    DOI
    10.1183/13993003.01033-2018
    ISSN
    1399-3003
    School
    School of Physiotherapy and Exercise Science
    URI
    http://hdl.handle.net/20.500.11937/72357
    Collection
    • Curtin Research Publications
    Abstract

    Copyright ©ERS 2018. Recently, this international task force reported the general considerations for bronchial challenge testing and the performance of the methacholine challenge test, a "direct" airway challenge test. Here, the task force provides an updated description of the pathophysiology and the methods to conduct indirect challenge tests. Because indirect challenge tests trigger airway narrowing through the activation of endogenous pathways that are involved in asthma, indirect challenge tests tend to be specific for asthma and reveal much about the biology of asthma, but may be less sensitive than direct tests for the detection of airway hyperresponsiveness. We provide recommendations for the conduct and interpretation of hyperpnoea challenge tests such as dry air exercise challenge and eucapnic voluntary hyperpnoea that provide a single strong stimulus for airway narrowing. This technical standard expands the recommendations to additional indirect tests such as hypertonic saline, mannitol and adenosine challenge that are incremental tests, but still retain characteristics of other indirect challenges. Assessment of airway hyperresponsiveness, with direct and indirect tests, are valuable tools to understand and to monitor airway function and to characterise the underlying asthma phenotype to guide therapy. The tests should be interpreted within the context of the clinical features of asthma.

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