Bronchial provocation tests: the rationale for using inhaled XXXX as a test for airway hyperresponsiveness.

@entity1 @entity2656 @entity565 @entity134 @entity112 @entity230 @entity2710 @entity2798
The use of @entity112 and @entity2710 is well established for identifying airway hyperresponsiveness (AHR) but the AHR to these agents is not specific for @entity565 diagnosis. Further, these agents do not identify or exclude exercise-induced @entity565 (EIA) so they are inappropriate for some occupational and sporting assessments. Measurement of AHR by pharmacological agents has other limitations in that a positive response does not necessarily identify a @entity1 who will respond to inhaled @entity230 and responses do not differentiate between doses of @entity230 . As most asthmatics remain hyperresponsive to these agents after treatment they have not been useful for guiding @entity134 dose reduction. Bronchial provocation tests (BPTs) with physical stimuli such as exercise, eucapnic @entity2798 and hypertonic saline have provided useful information on presence and severity of @entity565 and EIA. These tests however, can be time consuming and require more resources compared with the pharmacological tests. To simplify testing, a challenge has been developed that uses a dry powder of @entity2656 administered from a simple hand-held device. The @entity2656 is given in increasing doses from capsules containing from 5 mg to 40 mg. @entity2656 responsiveness identifies @entity1 with EIA and those who will respond to inhaled @entity230 . @entity2656 responsiveness is reduced following treatment with inhaled @entity230 , and some subjects become unresponsive within 6 to 8 weeks. Responsiveness to @entity2656 can be used to predict risk of exacerbation during back titration of @entity230 . Should this BPT become more readily available it would be the first to provide a common operating standard for use in the laboratory, office, or field.
