Bronchial Provocation Testing Can Be Improved by Using Dry Powder Adenosine Instead of Nebulized Adenosine Monophosphate

Baseline variables included in the multiple linear regression analysis for PC20 AMP were age, smoking status, blood eosinophils, FEV1, residual volume (RV), and ventilation heterogeneity of the conductive lung zone. The present work shows that bronchial provocation with dry powder adenosine is a sui...

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Published inAmerican journal of respiratory and critical care medicine Vol. 197; no. 3; pp. 391 - 394
Main Authors Lexmond, Anne J., Boudewijn, Ilse M., Hagedoorn, Paul, Schokker, Siebrig, Cox, Claire A., Vonk, Judith M., ten Hacken, Nick H. T., Frijlink, Henderik W., Vroegop, Sebastiaan J., van den Berge, Maarten
Format Journal Article
LanguageEnglish
Published United States American Thoracic Society 01.02.2018
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ISSN1073-449X
1535-4970
1535-4970
DOI10.1164/rccm.201704-0715LE

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Summary:Baseline variables included in the multiple linear regression analysis for PC20 AMP were age, smoking status, blood eosinophils, FEV1, residual volume (RV), and ventilation heterogeneity of the conductive lung zone. The present work shows that bronchial provocation with dry powder adenosine is a suitable method for measuring AHR in asthmatic subjects. [...]the new testing method allowed us to administer higher doses, resulting in fewer false-negative test results, and the degree of AHR to dry powder adenosine correlated well with the degree of AHR to nebulized AMP. There was, however, no apparent relationship between measures of airway obstruction at baseline and PD20 adenosine (e.g., only two out of nine had an FEV1/FVC ratio ,70%) or with their smoking status (four were current and five were former smokers). [...]we expect that increasing the top dose, which was arbitrarily chosen to be 80 mg in this study, could further reduce the number of false negatives and thus increase the test's sensitivity even more. [...]we have shown that bronchial provocation with dry powder adenosine is a suitable alternative to provocation with nebulized AMP, considering the good agreement between the tests and comparable baseline predictors. [...]dry powder adenosine appears to offer an improvement over nebulized AMP because of its higher sensitivity for less hyperresponsive subjects with asthma. n Author disclosures are available with the text of this letter at www.atsjournals.org.
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ISSN:1073-449X
1535-4970
1535-4970
DOI:10.1164/rccm.201704-0715LE