메타콜린 기관지유발시험에 음성반응을 보인 천식 환자들의 임상적 특징
Clinical Characteristics of Asthmatics Having Negative Results to Methacholine Bronchial Challenge Test
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Background: The methacholine bronchial challenge test is widely used to evaluate airway hyperresponsiveness in asthmatics;however some studies have reported a few asthmatics have negative methacholine bronchial challenge test results. We investigated the prevalence and clinical characteristics of this group of patients. Methods: We retrospectively analyzed the medical records of 118 patients diagnosed as having asthma who visited the Allergy Clinic of Ajou University Hospital between March 2010 and February 2011. Patients were divided into 2groups according to the methacholine bronchial challenge test results: group I included those with positive results (group I, n=92) and those with negative results (group II,n=26). Results: Of the 118 subjects, 26 (22.0%) showed negative methacholine bronchial challenge test results. The rates of late-onset asthma (65.4%), non-atopy (42.1%) and overweight (47.4%) were higher in group II than in group I (37%, P=0.013; 19.6%, P=0.008; and 23.9%, P=0.008). The baseline lung function and the frequency of severe asthma exacerbation were not significantly different between the 2groups. Conclusion: In this study, 22% of the asthmatic patients diagnosed by allergy specialists had negative methacholine bronchial challenge test results. It is suggested that late-onset asthma, non-atopy and overweight may be characteristic findings..
Abstract
Background: The methacholine bronchial challenge test is widely used to evaluate airway hyperresponsiveness in asthmatics;however some studies have reported a few asthmatics have negative methacholine bronchial challenge test results. We investigated the prevalence and clinical characteristics of this group of patients. Methods: We retrospectively analyzed the medical records of 118 patients diagnosed as having asthma who visited the Allergy Clinic of Ajou University Hospital between March 2010 and February 2011. Patients were divided into 2groups according to the methacholine bronchial challenge test results: group I included those with positive results (group I, n=92) and those with negative results (group II,n=26). Results: Of the 118 subjects, 26 (22.0%) showed negative methacholine bronchial challenge test results. The rates of late-onset asthma (65.4%), non-atopy (42.1%) and overweight (47.4%) were higher in group II than in group I (37%, P=0.013; 19.6%, P=0.008; and 23.9%, P=0.008). The baseline lung function and the frequency of severe asthma exacerbation were not significantly different between the 2groups. Conclusion: In this study, 22% of the asthmatic patients diagnosed by allergy specialists had negative methacholine bronchial challenge test results. It is suggested that late-onset asthma, non-atopy and overweight may be characteristic findings..
참고문헌 (31)
- "Korean asthma management guidline for adults 2011" (2011)[URL]
- "Global strategy for asthma and management and prevention" (2011)[URL]
- Sverrild A, "Airway hyperresponsiveness to mannitol and methacholine and exhaled nitric oxide: a random-sample population study", J Allergy Clin Immunol, 126, pp.952~958 (2010)
- Cockcroft DW, "Direct challenge tests: airway hyperresponsiveness in asthma: its measurement and clinical significance", Chest, 138, pp.18S~24S (2010)
- Anderson SD, "Bronchial provocation testing: the future", Curr Opin Allergy Clin Immunol, 11, pp.46~52 (2011)
- Anderson SD, "Comparison of mannitol and methacholine to predict exercise-induced bronchoconstriction and a clinical diagnosis of asthma", Respir Res, 10, pp.4~ (2009)
- McGrath KW, "Negative methacholine challenge tests in subjects who report physician-diagnosed asthma", Clin Exp Allergy, 41, pp.46~51 (2011)
- Choi IS, "Clinical evaluation of suspected asthma patients who underwent methacholine bronchoprovocation tests", Chonnam Med J, 37, pp.211~218 (2001)
- 한의령, "천식 의심환자에서 기도과민성과 관련된 공기 매개성 알레르겐", 천식 및 알레르기, 27(2), pp.105~110 (2007), 대한천식알레르기학회
- 김성수, "Airway Responsiveness to Inhaled Aspirin is Influenced by Airway Hyperresponsiveness in Asthmatic Patients", The Korean Journal of Internal Medicine, 25(3), pp.309~316 (2010), 대한내과학회
- Hanania NA, "Asthma in the elderly: Current understanding and future research needs--a report of a National Institute on Aging (NIA) workshop", J Allergy Clin Immunol, 128, pp.S4~S24 (2011)
- Crapo RO, "Guidelines for methacholine and exercise challenge testing-1999. This official statement of the American Thoracic Society was adopted by the ATS Board of Directors, July 1999", Am J Respir Crit Care Med, 161, pp.309~329 (1999)
- Park H, "Neutrophil activation following TDI bronchial challenges to the airway secretion from subjects with TDI-induced asthma", Clin Exp Allergy, 29, pp.1395~1401 (1999)
- Porsbjerg C, "Inflammatory subtypes in asthma are related to airway hyperresponsiveness to mannitol and exhaled NO", J Asthma, 46, pp.606~612 (2009)
- Sukkar MB, "Soluble RAGE is deficient in neutrophilic asthma and COPD", Eur Respir J, 39, pp.721~729 (2012)
- Reddel HK, "An official American Thoracic Society", European Respiratory Society statement: asthma control and exacerbations: standardizing endpoints for clinical asthma trials and clinical practice, 2009, pp.180, 59~99
- O'Byrne PM, "Provoked models of asthma: what have we learnt?", Clin Exp Allergy, 39, pp.181~192 (2009)
- Cockcroft DW, "Bronchial reactivity to inhaled histamine: a method and clinical survey", Clin Allergy, 7, pp.235~243 (1977)
- Cockcroft DW, "Mechanisms of airway hyperresponsiveness", J Allergy Clin Immunol, 118, pp.551~559 (2006)
- Cockcroft D, "Direct and indirect challenges in the clinical assessment of asthma", Ann Allergy Asthma Immunol, 103, pp.363~369 (2009)
- Shore SA, "Obesity, airway hyperresponsiveness, and inflammation", J Appl Physiol, 108, pp.735~743 (2010)
- Shore SA, "Obesity and asthma : possible mechanisms", J Allergy Clin Immunol, 121, pp.1087~1093 (2008)
- Shore SA, "Obesity, smooth muscle, and airway hyperresponsiveness", J Allergy Clin Immunol, 115, pp.925~927 (2005)
- Beuther DA, "Recent insight into obesity and asthma", Curr Opin Pulm Med, 16, pp.64~70 (2010)
- 박소영, "만성 기침환자에서 기관지 과민성, 아토피와 비만의 상관관계: 두 기관 연구", Tuberculosis and Respiratory Diseases, 71(1), pp.24~29 (2011), 대한결핵및호흡기학회
- Liu SF, "Relationship of allergic degree and PC20 level in adults with positive methacholine challenge test", Respiration, 72, pp.612~616 (2005)
- "Expert panel report 3 (EPR-3): guidelines for the diagnosis and management of asthma- full report 2007" (2007)[URL]
- Mehta V, "Time-dependent effects of inhaled corticosteroids on lung function, bronchial hyperresponsiveness, and airway inflammation in asthma", Ann Allergy Asthma Immunol, 103, pp.31~37 (2009)
- Sovijärvi AR, "Sustained reduction in bronchial hyperresponsiveness with inhaled fluticasone propionate within three days in mild asthma: time course after onset and cessation of treatment", Thorax, 58, pp.500~504 (2003)
- Nieminen MM, "Methacholine bronchial challenge using a dosimeter with controlled tidal breathing", Thorax, 43, pp.896~900 (1988)
- 송현주, "천식환자에서 아데노신을 이용한 기관지유발시험의 이상적 의의", 천식 및 알레르기, 24(3), pp.299~304 (2004), 대한천식알레르기학회