Allergy, Asthma & Respiratory Disease

The Korean Academy of Asthma, Allergy and Clinical Immunology (대한천식알레르기학회)
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The KAAACI Standardization Committee Report on the procedure and application of the bronchial provocation tests

기관지유발검사 시행과 해석: 전문가 의견서

  • Lim, Kyung-Hwan (Department of Internal Medicine, Armed Forces Capital Hospital) ;
  • Kim, Min-Hye (Department of Internal Medicine, Ewha Womans University School of Medicine) ;
  • Yang, Min-Suk (Department of Internal Medicine, Seoul Metropolitan Government - Seoul National University Boramae Medical Center) ;
  • Song, Woo-Jung (Department of Internal Medicine, Seoul National University College of Medicine) ;
  • Jung, Jae-Woo (Department of Internal Medicine, Chung-Ang University College of Medicine) ;
  • Lee, Jeongmin (Department of Pediatrics, Yonsei University Wonju College of Medicine) ;
  • Suh, Dong In (Department of Pediatrics, Seoul National University College of Medicine) ;
  • Shin, Yoo Seob (Department of Allergy and Clinical Immunology, Ajou University School of Medicine) ;
  • Kwon, Jae-Woo (Department of Internal Medicine, Kangwon National University School of Medicine) ;
  • Kim, Sae-Hoon (Department of Internal Medicine, Seoul National University Bundang Hospital) ;
  • Kim, Sang-Heon (Department of Internal Medicine, Hanyang University College of Medicine) ;
  • Lee, Byung-Jae (Division of Allergy, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Cho, Sang-Heon (Department of Internal Medicine, Seoul National University College of Medicine) ;
  • the Korean Academy of Asthma, Allergy and Clinical Immunology Standardization Committee (the Korean Academy of Asthma)
  • 임경환 (국군수도병원 내과) ;
  • 김민혜 (이화여자대학교 의과대학 내과학교실) ;
  • 양민석 (서울대학교 의과대학 보라매병원 내과) ;
  • 송우정 (서울대학교 의과대학 내과학교실) ;
  • 정재우 (중앙대학교 의과대학 내과학교실) ;
  • 이정민 (연세대학교 원주의과대학 소아청소년과학교실) ;
  • 서동인 (서울대학교 의과대학 소아청소년과학교실) ;
  • 신유섭 (아주대학교 의과대학 알레르기내과학교실) ;
  • 권재우 (강원대학교 의학전문대학원 내과학교실) ;
  • 김세훈 (서울대학교 의과대학 분당병원 내과) ;
  • 김상헌 (한양대학교 의과대학 내과학교실) ;
  • 이병재 (성균관대학교 의과대학 내과학교실) ;
  • 조상헌 (서울대학교 의과대학 내과학교실) ;
  • 대한천식알레르기학회 표준화위원회 (대한천식알레르기학회)
  • Received : 2017.09.01
  • Accepted : 2017.09.19
  • Published : 2018.01.31
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Abstract

Bronchial provocation tests are of value in the evaluation of airway hyperresponsiveness. Nonspecific bronchial challenge (methacholine, mannitol, exercise, etc.) is used when the symptoms, physical examination, and measurements of pulmonary function are unremarkable in the diagnosis of asthma, when a patient is suspected of having occupational asthma or exercise-induced bronchoconstriction (EIB), and when a screening test for asthma or EIB is required for some occupational groups in whom bronchospasm would pose an unacceptable hazard. Methacholine inhalation challenge is most widely used pharmacologic challenge and highly sensitive. For appropriate interpretation of the results of methacholine provocation, it is important to perform the test with the standardized protocol and to recognize that inhalation methods significantly influence the sensitivity of the procedure. Indirect challenges (e.g., mannitol and exercise) correlate with airway inflammation and are more specific but less sensitive for asthma. Indirect provocation tests are used to confirm asthma, to differentiate asthma from other airway diseases, and to evaluate EIB.

Keywords

Acknowledgement

Supported by : Korea Centers for Disease Control and Prevention

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