Realising the potential of various inhaled airway challenge agents through improved delivery to the lungs

Anne J. Lexmond*, Dave Singh, Henderik W. Frijlink, Graham W. Clarke, Clive P. Page, Ben Forbes, Maarten van den Berge

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

3 Citations (Scopus)
231 Downloads (Pure)


Inhaled airway challenges provoke bronchoconstriction in susceptible subjects and are a pivotal tool in the diagnosis and monitoring of obstructive lung diseases, both in the clinic and in the development of new respiratory medicines. This article reviews the main challenge agents that are in use today (methacholine, mannitol, adenosine, allergens, endotoxin) and emphasises the importance of controlling how these agents are administered. There is a danger that the optimal value of these challenge agents may not be realised due to suboptimal inhaled delivery; thus considerations for effective and reproducible challenge delivery are provided. This article seeks to increase awareness of the importance of precise delivery of inhaled agents used to challenge the airways for diagnosis and research, and is intended as a stepping stone towards much-needed standardisation and harmonisation in the administration of inhaled airway challenge agents.

Original languageEnglish
Pages (from-to)27-35
Number of pages9
JournalPulmonary Pharmacology & Therapeutics
Early online date10-Jan-2018
Publication statusPublished - Apr-2018


  • Asthma
  • Bronchial challenge test
  • Bronchial hyperresponsiveness
  • Delivery method optimisation
  • Delivery method standardisation
  • Drug delivery
  • adenosine
  • allergen
  • endotoxin
  • lipopolysaccharide
  • mannitol
  • methacholine
  • aerosol
  • bronchial challenge testing
  • bronchoconstriction
  • disease severity
  • drug delivery system
  • drug distribution
  • human
  • inhalation test
  • inhaled airway challenge
  • morphology
  • nebulization
  • oropharynx
  • priority journal
  • respiratory tract disease assessment
  • review
  • standardization
  • tracheobronchial tree

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