Direct-Writing Recorder of the Dose-Response Curves of the Airway to Methacholine: Clinical Application

doi:10.1378/chest.80.5.600

Chest

Volume 80, Issue 5, November 1981, Pages 600-606

https://doi.org/10.1378/chest.80.5.600 Get rights and content

We report a new device for examining the bronchial hyperresponsiveness by directly writing the dose-response curve of respiratory resistance (Rrs) during the continuous inhalation of the methacholine in stepwise incremental concentrations. Respiratory resistance was measured by the forced oscillation method. We found that the Rrs began to increase at a certain threshold concentration of methacholine (bronchial sensitivity) and that it has a curvilinear slope (bronchial reactivity). Subsequent inhalation of the bronchodilator drug returned the Rrs to the control level. Thus, we were able to examine bronchohyperresponsiveness in the patterns of the cumulative dose-response curves of methacholine. All normal subjects were nonresponders; while all of the asthmatic subjects, 63 percent (10) of the 16 patients with chronic bronchitis and 50 percent (7) of the 14 patients with acute bronchitis were responders. The dose-response curves were reproducible. Our device may be clinically applicable for examinations of bronchial hyperresponsiveness and for screening tests.

Section snippets

MATERIALS AND METHODS

We studied ten normal subjects (all men, nine nonsmokers and one smoker; mean age, 30 years) without cardiopulmonary disease and without any allergy history or family history of allergy; 14 patients with acute bronchitis (eight men and six women; mean age, 44 years); 16 patients with chronic bronchitis (eight men and eight women; mean age, 48 years); and 60 patients with extrinsic asthma (36 men and 24 women; mean age, 42 years). Chronic bronchitis was diagnosed on the basis of the clinical

Results

Figure 2 shows the dose-response curve in a patient with bronchial asthma. In bronchial asthma after the Rrs remained at an almost constant value for a short period, it increased curvilinearly after a threshold concentration of methacholine and decreased rapidly after the inhalation of metaproterenol. In general, the patterns in the cases of bronchial asthma were similar to isosceles triangles. On the other hand, in the normal subjects, the Rrs did not increase up to the maximum concentration

Validity of the Method

The bronchial provocation test is widely used, not only for examining the bronchial responsiveness in various pulmonary disease, but also for diagnosing bronchial asthma; however, since the method of examination has not yet been established, each investigator uses his own method. Therefore, the comparison of data among different laboratories has been difficult. Recently Chai et al³ reported the standardizations of the procedures for bronchial inhalation challenge for antigen, methacholine, and

ACKNOWLEDGEMENT

We wish to express our gratitude for the measurement of particle sizes of nebulizers to Mr. H. Shimizu, T. Kobayashi, and H. Inaba, Tohoku University School of Technology, and for the preparation of this report to Mr. P. Cantor, Ms. K. Toda, and Ms. S. Omori.

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Chest

Clinical InvestigationsDirect-Writing Recorder of the Dose-Response Curves of the Airway to Methacholine: Clinical Application

Section snippets

MATERIALS AND METHODS

Results

Validity of the Method

ACKNOWLEDGEMENT

J Allergy Clin Immunol

J Allergy Clin Immunol

J Allergy Clin Immunol

Definitions and classifications of chronic bronchitis, asthma and pulmonary emphysema

Am Rev Respir Dis

Airway response to carbochol in normal and asthmatic subjects: distinction between bronchial sensitivity and reactivity

Am Rev Respir Dis

Maximum expiratory flow rates in induced bronchoconstriction in man

J Clin Invest

Maximum expiratory flow and total respiratory resistance during induced bronchoconstriction in asthmatic subjects

Am Rev Respir Dis

Spirometry-induced bronchial obstruction

Am Rev Respir Dis

Airway responses to methacholine in allergic and nonallergic subjects

Am Rev Respir Dis

Relationship between bronchial reactivity airway caliber and severity of asthma

Am Rev Respir Dis

Clinical Investigations
Direct-Writing Recorder of the Dose-Response Curves of the Airway to Methacholine: Clinical Application