title: Asthma control test (ACT): comparison with clinical, functional, and biological markers of asthma control.
abstract: BACKGROUND
  Asthma Control Test (ACT) is a simple tool for assessing the level of asthma control in clinical practice, and it has been validated in comparison with a general clinical assessment of asthma control, including forced expiratory volume in the first second (FEV(1)).
  
  
  OBJECTIVE
  To evaluate the relationship between ACT score and clinical and functional findings of asthma control and biomarkers of airway inflammation.
  
  
  METHODS
  A total of 68 asthmatic patients observed in our asthma clinic (33 regularly treated with inhaled corticosteroids (ICS) and 35 ICS-naïve) filled ACT questionnaire and underwent the following measurements: (a) FEV(1) before and after salbutamol; (b) exhaled nitric oxide; (c) bronchial hyperresponsiveness to methacholine; (d) sputum eosinophil count; and (e) daytime and nighttime symptoms, rescue salbutamol, and twice-daily peak expiratory flow (PEF) recording on a 4-week diary card.
  
  
  RESULTS
  ACT score significantly correlated with symptom score, rescue medication use, and PEF variability, but not with FEV(1), FEV(1) reversibility, and markers of airway inflammation, which could not distinguish controlled from uncontrolled patients according to ACT, regardless of ICS treatment.
  
  
  CONCLUSIONS
  ACT score is a valid tool to simply assess the current level of asthma control in terms of symptoms, rescue medication use, and PEF variability. Pulmonary function and biomarkers of airway inflammation are not related to the clinical asthma control as assessed by ACT and may represent additional measurements potentially useful in asthma management.
authors.affiliation: Section of Respiratory Diseases, Cardio-Thoracic and Vascular Department, University of Pisa, Pisa, Italy.
authors.forename: Lorenza
authors.initials: L
authors.lastname: Melosini
authors.forename: Federico Lorenzo
authors.initials: FL
authors.lastname: Dente
authors.forename: Elena
authors.initials: E
authors.lastname: Bacci
authors.forename: Maria Laura
authors.initials: ML
authors.lastname: Bartoli
authors.forename: Silvana
authors.initials: S
authors.lastname: Cianchetti
authors.forename: Francesco
authors.initials: F
authors.lastname: Costa
authors.forename: Antonella
authors.initials: A
authors.lastname: Di Franco
authors.forename: Laura
authors.initials: L
authors.lastname: Malagrinò
authors.forename: Federica
authors.initials: F
authors.lastname: Novelli
authors.forename: Barbara
authors.initials: B
authors.lastname: Vagaggini
authors.forename: Pierluigi
authors.initials: P
authors.lastname: Paggiaro
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D058666:Adrenergic beta-2 Receptor Agonists / Q000627:therapeutic use; D000328:Adult; D000420:Albuterol / Q000494:pharmacology / Q000627:therapeutic use; D001249:Asthma / Q000175:diagnosis* / Q000188:drug therapy* / Q000378:metabolism / Q000503:physiopathology; D015415:Biomarkers / Q000378:metabolism*; D001944:Breath Tests; D001985:Bronchial Provocation Tests; D004804:Eosinophils / Q000473:pathology; D005260:Female; D005541:Forced Expiratory Volume / Q000187:drug effects / Q000502:physiology; D006801:Humans; D008297:Male; D016210:Methacholine Chloride / Q000494:pharmacology; D008875:Middle Aged; D009504:Neutrophils / Q000473:pathology; D009569:Nitric Oxide / Q000378:metabolism; D010366:Peak Expiratory Flow Rate / Q000502:physiology; D013183:Sputum / Q000166:cytology; D011795:Surveys and Questionnaires
chemical_list: D000305:Adrenal Cortex Hormones; D058666:Adrenergic beta-2 Receptor Agonists; D015415:Biomarkers; D016210:Methacholine Chloride; D009569:Nitric Oxide; D000420:Albuterol