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  1. S. Kazani,
  2. J. Sadeh,
  3. S. Bunga,
  4. N. Khan,
  5. M. E. Wechsler,
  6. A. Deykin,
  7. E. Israel
  1. Brigham and Women's Hospital, Harvard Medical School, Boston, MA


Aim Studies have reported contradictory results on the relationship between airway hyperresponsiveness to methacholine (Mch) and that elicited by hypertonic saline (HS) inhalation. We investigated the correlation between Mch-PC20 and HS-PD20 in mild asthmatics who had performed both challenges in a research setting.

Methods We assembled data on mild asthmatics on prn b-agonists, with a history of positive response to Mch (PC20 ≥ 8 mg/mL), who had undergone a staged 3% saline challenge. Mean time between challenges was 23 months (range 0.1-74, SD 21). We also compared the bronchial reactivity to exhaled breath condensate (EBC) pH, a putative marker of airway inflammation.

Results Subject data:

Of the 24 subjects, 16 (67%) were responsive to the HS challenge. Nonresponders were assigned an HS-PD20 value of 74 mL. HS-PD20 correlated significantly with Mch-PC20 (r = .52, p = .0089). EBC pH did not have a significant relationship with either HS-PD20 or Mch-PC20.

Conclusion HS and Mch reactivity provide similar assessments of airway reactivity in asthmatics not on controller medications. Considering the stability of the correlation, these data suggest that HS may be a substitute for Mch challenge. Neither measure of hyperresponsiveness correlates with EBC pH.

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