PMID- 26257384 OWN - NLM STAT- MEDLINE DCOM- 20180423 LR - 20180423 IS - 1752-699X (Electronic) IS - 1752-6981 (Linking) VI - 11 IP - 4 DP - 2017 Jul TI - Adenosine monophosphate is not superior to histamine for bronchial provocation test for assessment of asthma control and symptoms. PG - 470-480 LID - 10.1111/crj.12360 [doi] AB - BACKGROUND: Adenosine monophosphate (AMP) may reflect airway inflammation and hyperresponsiveness, but relationship between AMP and histamine (His, a conventional stimulus) bronchial provocation test (BPT) in asthma is not fully elucidated. OBJECTIVES: To compare both BPTs and determine their utility in reflecting changes of asthmatic symptoms. METHODS: BPTs were performed in a cross-over fashion, at 2-4 day intervals. Cumulative doses eliciting 20% FEV(1) fall (PD(20) FEV(1) ), diagnostic performance and adverse events (AEs) were compared. Patients with PD(20) FEV(1) lower than geometric mean were defined as responders, otherwise poor responders. Patients with uncontrolled and partly controlled asthma, who maintained their original inhaled corticosteroids therapy, underwent reassessment of airway responsiveness and asthmatic symptoms 3 and 6 months after. RESULTS: Nineteen uncontrolled, 22 partly controlled and 19 controlled asthmatic patients and 24 healthy subjects were recruited. Lower PD(20) FEV(1) geometric means were associated with poorer asthma control in His-BPT (0.424 mumol vs 1.684 mumol vs 3.757 mumol), but not AMP-BPT (11.810 mumol vs 7.781 mumol vs 10.220 mumol). Both BPTs yielded similar overall diagnostic performance in asthma (area under curve: 0.842 in AMP-BPT vs 0.850 in His-BPT). AEs, including wheezing and tachypnea, were similar and mild. Ten patients with uncontrolled and 10 partly controlled asthma were followed-up. At months 3 and 6, we documented an increase in PD(20) FEV(1) -AMP and PD(20) FEV(1) -His, which did not correlate with reduction asthmatic symptom scores. This overall applied in responders and poor responders of AMP-BPT and His-BPT. CONCLUSION: Despite higher screening capacity of well-controlled asthma, AMP-BPT confers similar diagnostic performance and safety with His-BPT. AMP-BPT might not preferentially reflect changes asthmatic symptoms. CI - (c) 2015 John Wiley & Sons Ltd. FAU - Wu, Fan AU - Wu F AD - State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Disease, First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, Guangdong, China. AD - Affiliated Liwan Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China. FAU - Guan, Wei-Jie AU - Guan WJ AD - State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Disease, First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, Guangdong, China. FAU - Gao, Yi AU - Gao Y AD - State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Disease, First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, Guangdong, China. FAU - An, Jia-Ying AU - An JY AD - State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Disease, First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, Guangdong, China. FAU - Xie, Yan-Qing AU - Xie YQ AD - State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Disease, First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, Guangdong, China. FAU - Liu, Wen-Ting AU - Liu WT AD - State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Disease, First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, Guangdong, China. FAU - Yu, Xin-Xin AU - Yu XX AD - State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Disease, First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, Guangdong, China. FAU - Zheng, Jin-Ping AU - Zheng JP AD - State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Disease, First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, Guangdong, China. LA - eng PT - Comparative Study PT - Journal Article PT - Observational Study DEP - 20150910 PL - England TA - Clin Respir J JT - The clinical respiratory journal JID - 101315570 RN - 0 (Adrenal Cortex Hormones) RN - 415SHH325A (Adenosine Monophosphate) RN - 820484N8I3 (Histamine) SB - IM MH - Adenosine Monophosphate/*administration & dosage/adverse effects/pharmacology MH - Administration, Inhalation MH - Adrenal Cortex Hormones/administration & dosage/therapeutic use MH - Adult MH - Asthma/*diagnosis/drug therapy/physiopathology MH - Bronchial Hyperreactivity/diagnosis MH - Bronchial Provocation Tests/*methods MH - Cross-Sectional Studies MH - Female MH - Forced Expiratory Volume/drug effects MH - Histamine/*administration & dosage/adverse effects/pharmacology MH - Humans MH - Male MH - Middle Aged OTO - NOTNLM OT - adenosine monophosphate - asthma - bronchial provocation test - histamine - responder EDAT- 2015/08/11 06:00 MHDA- 2018/04/24 06:00 CRDT- 2015/08/11 06:00 PHST- 2015/03/05 00:00 [received] PHST- 2015/07/03 00:00 [revised] PHST- 2015/08/03 00:00 [accepted] PHST- 2015/08/11 06:00 [pubmed] PHST- 2018/04/24 06:00 [medline] PHST- 2015/08/11 06:00 [entrez] AID - 10.1111/crj.12360 [doi] PST - ppublish SO - Clin Respir J. 2017 Jul;11(4):470-480. doi: 10.1111/crj.12360. Epub 2015 Sep 10.