Investigative bronchoprovocation and bronchoscopy in airway diseases

William W. Busse, Adam Wanner, Kenneth Adams, Herbert Y. Reynolds, Mario Castro, Badrul Chowdhury, Monica Kraft, Robert J. Levine, Stephen P. Peters, Eugene J. Sullivan

Research output: Contribution to journalArticle

61 Scopus citations

Abstract

Rationale: Basic and clinical research strategies used for many lung diseases have depended on volunteer subjects undergoing bronchoscopy to establish access to the airways to collect biological specimens and tissue, perhaps with added bronchoprovocation in asthma syndromes. These procedures have yielded a wealth of important scientific information. Since the last critical review more than a decade ago, some of the techniques and applications have changed, and untoward events have occurred, raising safety concerns and increasing institutional review scrutiny. Objectives and Methods:To reappraise these investigational methods in the context of current knowledge, the National Heart, Lung, and Blood Institute and the National Institute of Allergy and Infectious Diseases of the National Institutes of Health convened a working group to review these procedures used for airway disease research, emphasizing asthma and chronic obstructive pulmonary disease. Main Results: The group reaffirmed the scientific importance of investigative bronchoscopy and bronchoprovocation, even as less invasive technologies evolve. The group also considered the safety of bronchoscopy and bronchoprovocation with methacholine and antigen to be acceptable for volunteer subjects and patients, but stressed the need to monitor this closely and to emphasize proper training of participating medical research personnel. Issues were raised about vulnerable volunteers, especially children who need surrogates for informed consent. Conclusion: This review of investigative bronchoscopy and bronchoprovocation could serve as the basis for future guidelines for the use of these procedures in the United States.

Original languageEnglish (US)
Pages (from-to)807-816
Number of pages10
JournalAmerican journal of respiratory and critical care medicine
Volume172
Issue number7
DOIs
StatePublished - Oct 1 2005

Keywords

  • Airway hyperresponsiveness
  • Asthma
  • Bronchoalveolar lavage
  • Chronic obstructive pulmonary disease
  • Lidocaine
  • Methacholine
  • Segmental allergen challenge

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

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    Busse, W. W., Wanner, A., Adams, K., Reynolds, H. Y., Castro, M., Chowdhury, B., Kraft, M., Levine, R. J., Peters, S. P., & Sullivan, E. J. (2005). Investigative bronchoprovocation and bronchoscopy in airway diseases. American journal of respiratory and critical care medicine, 172(7), 807-816. https://doi.org/10.1164/rccm.200407-966WS