Giovannini M, Valli M, Ribuffo V, Melara R, Cappiello G, Businarolo E, Andreani A
Pulmonary Diseases Department, Mirandola Hospital, Via Fogazzaro 6, 41100, Modena, Italy, E-mail:
Eur Ann Allergy Clin Immunol. 2014 May;46(3):109-13.
Usually, hyperresponsiveness to inhaled methacholine is considered closely associated with a diagnosis of bronchial asthma. Recently, it has been clearly pointed out that bronchial hyperreactivity (BHR) is not a constant feature of asthma and that this condition is not always related to airways inflammation. In the present study we evaluated 42 Patients (21 positive and 21 negative for bronchial hyperreactivity, BHR) with the aim to determine the effect of Methacholine Challenge Testing (MCT) on the levels of exhaled nitric oxide (NO). Higher FeNO levels were found before methacholine provocation in the group that eventually resulted positive to the challenge, while after the challenge in both groups FeNO decreased in similar way, with no statistical difference. These data confirm that MCT is a relevant test for asthma diagnosis, but it is not always related to the severity of bronchial inflammation, while FeNO levels in our study have limited clinical significance when evaluated out of asthma exacerbation.
通常，对吸入乙酰甲胆碱的高反应性被认为与支气管哮喘的诊断密切相关。最近，已经明确指出支气管高反应性（BHR）并非哮喘的恒定特征，并且这种情况并不总是与气道炎症相关。在本研究中，我们评估了42例患者（21例支气管高反应性阳性和21例阴性），目的是确定乙酰甲胆碱激发试验（MCT）对呼出一氧化氮（NO）水平的影响。最终激发试验呈阳性的组在乙酰甲胆碱激发前发现较高的呼出一氧化氮水平，而激发后两组呼出一氧化氮均以相似方式下降，无统计学差异。这些数据证实MCT是哮喘诊断的相关试验，但它并不总是与支气管炎症的严重程度相关，而在我们的研究中，在哮喘加重期之外评估时，呼出一氧化氮水平的临床意义有限。
