Inhaled mannitol as a test for bronchial hyper-responsiveness

Abstract

Bronchial provocation tests (BPTs) are useful for identifying one of the key features of asthma: bronchial hyper-responsiveness (BHR). The symptoms of asthma are not always reflective of the underlying pathophysiology of asthma and there is a need for objective tests to identify the presence and severity of BHR. A new BPT, involving the inhalation of dry powder mannitol, has recently been approved to identify BHR and is now in use as a diagnostic tool for currently active asthma. Airway sensitivity to mannitol identifies BHR that is dependent upon the presence of airway inflammation and would probably benefit from treatment with inhaled corticosteroids. The mannitol BPT is available commercially as a (single-use) test kit (Aridol™/Osmohale™), with the only additional requirement to perform the test being a spirometer. Accordingly, the mannitol BPT provides a point-of-need tool to identify BHR to assist in the diagnosis of asthma.

Keywords::

• asthma
• bronchial hyper-responsiveness
• bronchial provocation
• diagnosis
• mannitol

Financial & competing interests disclosure

Sandra Anderson is the inventor on the patents that cover the application for inhaled mannitol. The patent is owned by the Sydney South West Area Health Service (SSWAHS) and the rights to commercialize the intellectual property have been licensed to Pharmaxis Ltd (Australia). Sandra Anderson and John Brannan purchased shares on the open market and each receives a 10% share of royalties distributed to the SSWAHS for the sale of Aridol™. Sandra Anderson and John Brannan act as consultants to Pharmaxis Ltd. when requested. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.