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| |  MethacT Shows Greater Sensitivity to Bronchial Hyperresponsiveness Than Adenosine: Presented at AAAAI By Carole VanSickle Ellis NEW ORLEANS -- March 1, 2010 -- When determining whether a patient has bronchial asthma, it appears that a test with methacholine will be more sensitive than adenosine in clinical practice, according to research presented here on February 27 at the 2010 American Academy of Allergy, Asthma & Immunology (AAAAI) Annual Meeting. However, isolated instances of bronchial hyperresponsiveness to adenosine may be found and associated to high exhaled nitric oxide (FeNO) levels. Diego Lumelli, Fundacíon Jiménez Díaz, Madrid, Spain, and colleagues selected a 46-patient study group from patients at the clinic in the J. Sastre Allergy Department on site at the Fundacíon Jiménez Díaz. The patients had a mean age of 40.6 years. Patients had asthma-like symptoms of coughing, dyspnoea, and/or wheezing. A 2-minute tidal volume method was used for both methacholine and adenosine. Prior to the study, inhaled corticosteroids had been discontinued for 3 weeks, and B2 inhalers were not used 24 hours prior to the study. The MethacT test was performed first in all cases. One hour later, the adenosine 5’-monophosphate (AMP) challenge was performed in all cases. MethacT was positive in 22 of the 46 patients, while 15 had a positive AMP test in 20 minutes (AMP-PC20), and 17 had a positive AMP test in 15 minutes (AMP-PC15). In 11 of the patients, MethacT resulted in a positive, but AMP-PC15 resulted in a negative, and in 5 patients MethacT was negative, but AMP-PC20 showed a positive. In this final group, 4 out of 5 also showed high FeNO values. Atopy, Asthma Control Test score, FeNO, and forced expiratory volume in 1 second predictions were not associated with positive results to either test. The research indicates that MethacT tends to be more sensitive than adenosine in demonstrating bronchial hyperresponsiveness and helping diagnose bronchial asthma. Isolated hyperresponsiveness to adenosine and the associated high FeNO levels should be considered, however, during the diagnostic process since the results seem to indicate that patients with high FeNO levels might be more sensitive to the adenosine method than the methacholine method. The research team stated that the 1-hour span of time in between the 2 tests did not appear to interfere with the results. [Presentation title: Comparison of Bronchial Hyperresponsiveness to Methacholine and Adenosine in Clinical Practice. Abstract 6]
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