Bronchial provocation tests in clinical practice

Bronchial hyperresponsiveness, which consists of an exaggerated response of the airways to bronchoconstrictor stimuli, is one of the main characteristics of asthma, presented in nearly all asthmatic patients. Bronchial hyperresponsiveness may also be present in other diseases, such as allergic rhini...

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Bibliographic Details
Authors: Borges, Marcos de Carvalho, Ferraz, Erica, Vianna, Elcio Oliveira
Format: article
Status:Published version
Publication Date:2011
Country:Brasil
Institution:Associação Paulista de Medicina
Repository:São Paulo medical journal (Online)
Language:English
OAI Identifier:oai:ojs.diagnosticoetratamento.emnuvens.com.br:article/1614
Online Access:https://periodicosapm.emnuvens.com.br/spmj/article/view/1614
Access Level:Open access
Keyword:Testes de provocação brônquica
Asma
Broncoconstrição
Diagnóstico
Hipersensibilidade respiratória
Bronchial provocation test
Asthma
Bronchoconstriction
Diagnosis
Respiratory hypersensitivity
Description
Summary:Bronchial hyperresponsiveness, which consists of an exaggerated response of the airways to bronchoconstrictor stimuli, is one of the main characteristics of asthma, presented in nearly all asthmatic patients. Bronchial hyperresponsiveness may also be present in other diseases, such as allergic rhinitis, chronic obstructive pulmonary disease, cystic fibrosis, heart failure and respiratory infection, and with some medications, such as β-blockers. Bronchial provocation tests (also known as bronchial challenges) are used to evaluate bronchial responsiveness. These tests have become increasingly used over the last 20 years, with the development and validation of accurate, safe and reproducible tests, and with the publication of welldetailed protocols. Several stimuli can be used in a bronchial challenge, and they are classified as direct and indirect stimuli. There are many indications for a bronchial challenge. In this review, we discuss the main differences between direct and indirect stimuli, and the use of bronchial challenges in clinical practice, especially for confirming diagnoses of asthma, exercise-induced bronchoconstriction and coughvariant asthma, and for use among elite-level athletes.