Schwartz Nofrat, Grossman Alon, Levy Yuval, Schwarz Yehuda
Surgeon General Office Headquarters, The Israeli Air Force, Tel Hashomer, Israel.
J Asthma. 2012 May;49(4):336-41. doi: 10.3109/02770903.2012.672613.
Methacholine challenge test is used to identify airway hyperresponsiveness (AHR). Total eosinophil counts in peripheral blood reflect asthmatic activity and are useful for early detection of exacerbations. Correlation between the two is poorly defined, particularly in asymptomatic subjects.
The aim is to define correlation between methacholine challenge test and peripheral blood eosinophilia.
All flight academy candidates evaluated in the Israeli Air Force Aero Medical Center between the years 2010 and 2011 were included. Candidates were referred to methacholine challenge test based on a personal history of asthma or wheezing in childhood, a first-degree relative with the diagnosis of asthma, or an abnormal spirometry. All methacholine tests were analyzed retrospectively.
Asymptomatic subjects with a positive methacholine challenge test demonstrated significantly (p < .002) higher levels of absolute eosinophil count compared with the group with a negative methacholine test (0.46 ± 0.21 vs. 0.21 ± 0.01 K/μL). Total white blood cell and neutrophil counts were higher in the group with a positive methacholine test compared with the group with a negative methacholine test, but to a lesser extent (7.1 ± 0.25 vs. 6.6 ± 0.09 K/μL, p = .04 and 3.9 ± 0.24 vs. 3.5 ± 0.07 K/μL, p = .04, respectively). No association was demonstrated between eosinophil count and severity of AHR expressed by the methacholine concentration evoking a response.
There is a strong association between eosinophil count and AHR in asymptomatic subjects.
乙酰甲胆碱激发试验用于识别气道高反应性（AHR）。外周血中嗜酸性粒细胞总数反映哮喘活动情况，有助于早期发现病情加重。两者之间的相关性定义不明确，尤其是在无症状受试者中。
旨在明确乙酰甲胆碱激发试验与外周血嗜酸性粒细胞增多之间的相关性。
纳入2010年至2011年在以色列空军航空医学中心接受评估的所有飞行学院候选人。根据儿童时期哮喘或喘息的个人病史、患有哮喘诊断的一级亲属或肺活量测定异常，将候选人转诊进行乙酰甲胆碱激发试验。所有乙酰甲胆碱试验均进行回顾性分析。
乙酰甲胆碱激发试验阳性的无症状受试者与乙酰甲胆碱试验阴性的组相比，绝对嗜酸性粒细胞计数水平显著更高（p <.002）（0.46±0.21 vs. 0.21±0.01 K/μL）。乙酰甲胆碱试验阳性组的总白细胞和中性粒细胞计数高于乙酰甲胆碱试验阴性组，但程度较轻（分别为7.1±0.25 vs. 6.6±0.09 K/μL，p =.04和3.9±0.24 vs. 3.5±0.07 K/μL，p =.04）。嗜酸性粒细胞计数与由引起反应的乙酰甲胆碱浓度所表达的AHR严重程度之间未显示出相关性。
在无症状受试者中，嗜酸性粒细胞计数与AHR之间存在密切关联。
