TY - JOUR T1 - Comparison of mannitol and methacholine challenge test for the diagnosis of asthma in athletes JF - European Respiratory Journal JO - Eur Respir J VL - 44 IS - Suppl 58 SP - P1821 AU - Malika Mustafina AU - Alexander Cherniak AU - Ludmila Shogenova AU - Zaurbec Aisanov AU - Alexander Chuchalin Y1 - 2014/09/01 UR - http://erj.ersjournals.com/content/44/Suppl_58/P1821.abstract N2 - The prevalence of exercise-induced bronchoconstriction (EIB) is reported to be high among elite athletes. Diagnosis methods can generally be divided into two categories, direct and indirect tests. Methacholine acts directly on acetylcholine receptors on smooth muscle causing contraction and airway narrowing. Provocation tests that use indirect stimuli (e.g. mannitol) cause smooth muscle contraction by release of endogenous mediators. Which method is more specific and sensitive for diagnosis of bronchial hyperresponsiveness (BHR) and EIB is therefore an essential question.Objective: to compare specificity and sensitivity of the mannitol challenge test (MT) and methacholine challenge test (MCT) for the diagnosis of bronchial asthma in athletes.Methods: 12 athletes (5 M/7 F, mean age 24.0±6.3 yrs) with respiratory symptoms were studied. Lung function with assessment of reversibility to salbutamol, MT and MCT were performed. The specificity and sensitivity of MT and MCT were evaluated.Results: Significant reversibility to salbutamol was found in 5 athletes. The fall in FEV1 following the methacholine inhalation was more than 20% in 8 athletes. The fall in FEV1 following the mannitol dry powder inhalation was more than 15% in 8 athletes. There was significant positive correlation between MCT-BHR and MT-BHR results. Both MCT and MT showed equally high specificity and sensitivity.Conclusion: Bronchial provocation tests provide objective criteria for exercise-induced bronchoconstriction and can be recommended to justify the use of inhaled beta2-agonists by athletes. Both the MCT and MT in athletes with respiratory symptoms had equally high specificity and sensitivity. ER -