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Comparative Study
. 2007 Sep;22(3):164-70.
doi: 10.3904/kjim.2007.22.3.164.

Airways are more reactive to histamine than to methacholine in patients with mild airway hyperresponsiveness, regardless of atopy

Inseon S Choi  1 , Seok Lee, Dae-Hyeon Kim, Se-Woong Chung, Yoon-Cheol Lee, Jae-Yeong Cho, Woo-Jin Lee
Affiliations
Comparative Study

Airways are more reactive to histamine than to methacholine in patients with mild airway hyperresponsiveness, regardless of atopy

Inseon S Choi et al. Korean J Intern Med. 2007 Sep.

Abstract

Background: The airway muscles from allergen-sensitized animals in vitro show a heightened response to histamine, but not to carbachol. This study investigated whether the airway responsiveness to histamine in vivo is comparable to that of methacholine in human subjects with varying degrees of atopy.

Methods: One-hundred-and-sixty-eight consecutive adult asthma patients or volunteers underwent bronchoprovocation tests to both histamine and methacholine after determining their blood eosinophil counts, serum total IgE levels and skin test reactivity to 10 common aeroallergens.

Results: The responsiveness to histamine was significantly related to that to methacholine (r=0.609, p<0.001), but many individuals with a negative methacholine test response showed a positive response to histamine. The histamine-bronchial reactivity index (BRindex) was significantly higher than the methacholine-BRindex in subjects with a positive response to none (n=69, p<0.01) or only one (n=42, p<0.001) of histamine and methacholine, while there was no significant difference in the subjects with positive responses to both of them (n=57). The histamine-BRindex was significantly higher than the methacholine-BRindex in the subjects with mild histamine hyperresponsiveness (n=58, 1.28+/-0.01 vs. 1.20+/-0.02, respectively, p<0.001). Both histamine and methacholine responsiveness was significantly related to the atopy markers. However, the histamine-BRindex/methacholine-BRindex ratio of the atopics was not significantly different from that of the non-atopics.

Conclusions: The airway responsiveness to histamine is comparable to that of methacholine in the subjects with positive responses to both histamine and methacholine, but the airway responsiveness to histamine is greater than that to methacholine in those subjects with mild airway hyperresponsiveness, regardless of atopy.

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Figures

Figure 1
Figure 1
Relationships of the bronchial reactivity index (BRindex), which was calculated using a formula: log10 (10 + the maximal % fall in FEV1/log10 (the dose in mg/dL of the stimulus required to produce it)), and maximal % fall in the forced expiratory volume in one second (FEV1) after a bronchial challenge between histamine and methacholine. The dashed line is the line of identity.
Figure 2
Figure 2
Comparisons of the bronchial reactivity index (BRindex) and maximal % fall in the forced expiratory volume in one second (FEV1) after a bronchial challenge between histamine and methacholine in the subjects with negative responses to both, a positive response to one, or positive responses to both histamine and methacholine tests.
Figure 3
Figure 3
Histamine (H)/methacholine (M)- bronchial reactivity index (BRindex) ratios in the study groups.
See this image and copyright information in PMC

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