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Methacholine Challenge Test (MCT) in Healthy Adults

Not yet recruiting
Conditions
Hyperreactive Airway Disease
Interventions
Diagnostic Test: Methacholine Challenge Test
Registration Number
NCT06509659
Lead Sponsor
Allergi- og Lungeklinikken, Elsinore
Brief Summary

Knowledge of Methacholine Challenge Test (MCT) and impedance Oscillometry (IOS) is limited. Only three studies have included adult patients, and none of these with healthy controls. The three studies have combined IOS and spirometry in the same test, although it is not recommended to perform IOS after a test that requires deep breathing, e.g. FEV1 measurement. Deep breathing is considered to affect the impedance via reduced tone in the smooth muscle.

Detailed Description

Asthma is a common chronic disease that is characterized by a history of variable respiratory symptoms and variable expiratory airflow limitation, and usually associated with airway hyperresponsiveness (GINA).

In general, FEV1 is used to test for airway hyperresponsiveness (AHR), and a 20% decrease after methacholine challenge test (MCT) is considered a positive test (Coates 2017; ERJ).

There is increasing recognition that the small airways are involved in 40-80% of patients with asthma, and the function of these airways is overlooked (the "silent zone") when measuring FEV1, which mainly reflects the function of the central airways.

Small airway dysfunction (SAD) can be assessed by IOS where pressure applied to the airways at a range of frequencies, and components of respiratory resistance and reactance are measured. Resistance at 5 Hz (R5) and 20 Hz (R20), respectively, represent total airway resistance and proximal airway resistance. The difference between these two values can be calculated (R5-R20). High R5-R20 and low reactance at 5 Hz (X5) indicate the presence of SAD.

Knowledge of MCT and IOS is limited. Only three studies have included adult patients, and none of these with healthy controls. These studies have combined IOS and spirometry in the same test, although it is not recommended to perform IOS after a test that requires deep breathing, e.g. FEV1 measurement. Deep breathing is considered to affect the impedance via reduced tone in the smooth muscle.

The investigators have the following objectives for these studies:

1. To determine the IOS response to MCT in healthy adults.

2. To investigate whether spirometry (FEV1) carried out in relation to MCT influences IOS by comparing the IOS response to MCT performed with and without spirometry in healthy adults.

Recruitment & Eligibility

Status
NOT_YET_RECRUITING
Sex
All
Target Recruitment
25
Inclusion Criteria

Forced expiratory volume in the 1. second (FEV1) >80% FEV1/FVC-ratio >0,7 FeNO <25 pbb Oxygen saturation (SatO2) >95% Negative methacholine Challenge Test = drop in FEV1 less than 20%

Exclusion Criteria

Any lung disease Lung symptoms Medicine for lung disease Tobacco smoking Ex-smokers with more than 5 package years BMI (body mass index) >40 kg/m2

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
Healthy controlsMethacholine Challenge TestNo lung disease or symptoms. Negative methacholine Challenge Test.
Primary Outcome Measures
NameTimeMethod
Oscillometry; R51-10 days from baseline and carried out without FEV1 measurement

Resistance at 5 Hz; kPa/L/s change from baseline

Oscillometry; R201-10 days from baseline and carried out without FEV1 measurement

Resistance at 20 Hz; kPa/L/s change from baseline

Oscillometry; X51-10 days from baseline and carried out without FEV1 measurement

Reactance at 5 Hz; kPa/L/s change from baseline

Oscillometry; AX1-10 days from baseline and carried out without FEV1 measurement

Area of reactance; kPa/L change from baseline

Oscillometry; Fres1-10 days from baseline and carried out without FEV1 measurement

Resonant frequency; Hz change from baseline

Secondary Outcome Measures
NameTimeMethod

Trial Locations

Locations (1)

Thomas Ringbæk

🇩🇰

Helsingør, Denmark

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