Reproducibility of response to nasal lysine-aspirin challenge in patients with aspirin-induced asthma.
BACKGROUND
Peak nasal inspiratory flow (PNIF) and acoustic rhinometry objectively measure the effects of nasal provocation testing. Although the latter is conventionally used in nasal lysine-aspirin challenge, use of the former in aspirin-induced asthma (AIA) has never been evaluated.


OBJECTIVE
To evaluate the reproducibility of PNIF and acoustic rhinometry following nasal lysine-aspirin challenge in AIA.


METHODS
Fourteen patients with a clear-cut history of AIA underwent nasal lysine-aspirin challenge at 2 separate visits 1 week apart. Both PNIF and minimum cross-sectional area (MCA) were measured using acoustic rhinometry for 120 minutes following standard nasal lysine-aspirin challenge (25 mg).


RESULTS
Prechallenge values were not significantly different at visit 1 vs visit 2 for mean [SEM] PNIF (128 [13] vs 127 [9] L/min) and MCA (6.89 [0.51] vs 6.94 [0.57] cm2). The mean (SEM) maximum percent PNIF change from baseline for visit 1 and visit 2 was -42 (5) and -42 (6), respectively, and the mean (SEM) average percent PNIF change from baseline was -25 (4) and -25 (6), respectively. The mean (SEM) maximum percent MCA change from baseline for visit 1 and visit 2 was -49 (4) and -48 (3), respectively, and the mean (SEM) average percent MCA change from baseline was -25 (8) and -24 (4), respectively. Coefficients of variation for maximum and average responses were 2.3% and 6.5%, respectively, for PNIF and 7.4% and 16.1% for MCA.


CONCLUSIONS
Measurement of PNIF following nasal lysine-aspirin challenge is a simple and reproducible alternative to acoustic rhinometry, with maximum response being a more reproducible outcome measure than average response.
Asthma & Allergy Research Group, Ninewells Hospital & Medical School, University of Dundee, Dundee, Scotland.
Daniel K C
DK
Lee
Kay
K
Haggart
Brian J
BJ
Lipworth
D000305:Adrenal Cortex Hormones / Q000008:administration & dosage; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects*; D001241:Aspirin / Q000009:adverse effects* / Q000031:analogs & derivatives*; D001249:Asthma / Q000139:chemically induced* / Q000188:drug therapy; D005260:Female; D006801:Humans; D007320:Inspiratory Capacity / Q000187:drug effects; D020024:Leukotriene Antagonists / Q000008:administration & dosage; D008239:Lysine / Q000009:adverse effects* / Q000031:analogs & derivatives*; D008297:Male; D008875:Middle Aged; D009299:Nasal Provocation Tests; D010366:Peak Expiratory Flow Rate / Q000187:drug effects; D015203:Reproducibility of Results; D013997:Time Factors
D000305:Adrenal Cortex Hormones; D000894:Anti-Inflammatory Agents, Non-Steroidal; D020024:Leukotriene Antagonists; D008239:Lysine; D001241:Aspirin; C010395:acetylsalicylic acid lysinate