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A bronchial challenge test is a medical test used to assist in the diagnosis of asthma. [1] The patient breathes in nebulized methacholine or histamine. Thus the test may also be called a methacholine challenge test or histamine challenge test respectively. Both drugs provoke bronchoconstriction, or narrowing of the airways.
Methacholine is primarily used to diagnose bronchial hyperreactivity, [1] which is the hallmark of asthma and also occurs in chronic obstructive pulmonary disease.This is accomplished through the bronchial challenge test, or methacholine challenge, in which a subject inhales aerosolized methacholine, leading to bronchoconstriction.
Bronchial hyperresponsiveness can be assessed with a bronchial challenge test. This most often uses products like methacholine or histamine . These chemicals trigger bronchospasm in normal individuals as well, but people with bronchial hyperresponsiveness have a lower threshold.
The methacholine challenge involves the inhalation of increasing concentrations of a substance that causes airway narrowing in those predisposed. If negative it means that a person does not have asthma; if positive, however, it is not specific for the disease.
Spirometry can also be part of a bronchial challenge test, used to determine bronchial hyperresponsiveness to either rigorous exercise, inhalation of cold/dry air, or with a pharmaceutical agent such as methacholine or histamine.
The specific inhalation challenge (SIC) is a diagnosis tool to assess airway responsiveness to "sensitizing" substances as opposed to nonspecific stimuli such as pharmacological agents (i.e. histamine, methacholine), cold air and exercise. [1]
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Medication challenge tests, such as the methacholine challenge test, have a lower sensitivity for detection of exercise-induced bronchoconstriction in athletes and are also not a recommended first-line approach in the evaluation of exercise-induced asthma. [13] Mannitol inhalation [14] [15] has been recently approved for use in the United States.