Source: Annual Congress 2003 - Assessing airway function: practicalities and clinical applications
Disease area: Airway diseases

Abstract

In bronchial challenge tests specific airway conductance ( sGaw ) is a more sensitive index of change in airways calibre than forced expiratory volume in 1 second ( FEV₁ ). The purpose of the present study was to compare the specificity of the change in sGaw and FEV₁ in bronchial challenge tests with histamine.
Methods: In 23 healthy subjects ( 13 males, 10 females ) a bronchial challenge test was performed ( doubling doses of histamine administered for 2 min. at 5-min. interval, 0.13 ml/ min. jet-nebulizer output. Subjects and their first degree relatives had to have no history of respiratory symptoms and allergy. Subjects had to have normal lung function, no medication and never been smoking. Response was measured first by sGaw, secondly by FEV₁.
Results: In baseline conditions mean FEV₁ ( ± SD ) was 4.2 ± 0.8 l. ( 104 % ± 13 % pred. ) and mean sGaw 2.94 ± 0.80 s^-1.kPa^-1. The PC₂₀FEV₁ was > 8 mg/ ml. in 18 subjects and ranged from 3.4 to 8 mg/ ml. in 5 subjects; PC₄₀sGaw was > 8 mg/ ml. in 5 subjects and ranging from 0.01 to 8 mg/ ml. in 18 subjects. In the group of 18 subjects with PC₂₀FEV₁ > 8 mg/ ml. mean increase in sGaw at 8 mg/ ml. was 50 % (range from - 18 % to + 94 % ). Using a cutoff value of 8 mg/ ml. specificity was 78 % for PC₂₀FEV₁ and 22 % for PC₄₀sGaw. Selection of lower cut-off values for PC₄₀sGaw did not improve specificity to a satifactory level.
Conclusion: In healthy subjects PC₄₀sGaw, in contrast to PC₂₀FEV₁, showed a very wide range of values. As a consequence in clinical bronchial responsiveness testing PC₄₀sGaw lacks specificity to distinguish between healthy subjects and asthmatics.

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Citations should be made in the following way:
R. Lunde, H. Bindels, J. A. van Noord (Heerlen, The Netherlands). A comparison of the response to inhaled histamine measured with FEV₁ and sGaw in healthy subjects. Eur Respir J 2003; 22: Suppl. 45, 3617

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