Skip to main content
SpringerLink
Log in

Aktuelles in der Asthmadiagnostik

Current aspects of asthma diagnostics

  • Leitthema
  • Published:
Der Pneumologe Aims and scope

Zusammenfassung

Die Asthmadiagnostik befindet sich im Umbruch. Messungen der Reversibilität und der bronchialen Hyperreagibilität werden neu bewertet, der Stellenwert des exhalierten Stickstoffmonoxids wird genauer definiert, die molekulare Allergologie und verschiedene Biomarker gewinnen eine zunehmende Bedeutung zur Identifikation personalisierter Zusatzoptionen in der Asthmatherapie. Dennoch werden die detaillierte Anamneseerhebung und die klinische Verlaufsbeurteilung ein zentraler Stützpfeiler der Asthmadiagnostik bleiben. Trotz aller Biomarker ist auch in Zukunft ein pneumologisch geschulter Arzt/eine pneumologisch geschulte Ärztin unverzichtbar, um die Diagnose Asthma korrekt stellen zu können.

Abstract

Diagnostic concepts for asthma are changing. The measurement and interpretation of reversibility and bronchial responsiveness are re-evaluated and the precise role of exhaled nitrogen monoxide (NO) tests in clinical practice is currently debated. In addition, molecular allergology and a variety of biomarkers are of growing importance for identification of personalized treatment options in asthma therapy. Nevertheless, despite all biomarkers a clinical diagnosis by a trained respiratory physician encompassing the medical history, the clinical examination and the clinical course and the response to treatment will be indispensible.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Abb. 1

Literatur

  1. Tinkelman DG, Price DB, Nordyke RJ, Halbert RJ (2006) Misdiagnosis of COPD and asthma in primary care patients 40 years of age and over. J Asthma 43:75–80

    Article  PubMed  Google Scholar 

  2. Luks VP, Vandemheen KL, Aaron SD (2010) Confirmation of asthma in an era of overdiagnosis. Eur Respir J 36:255–260

    Article  PubMed  CAS  Google Scholar 

  3. Quanjer PH, Stanojevic S, Cole TJ et al (2012) Multi-ethnic reference values for spirometry for the 3–95-yr age range: the global lung function 2012 equations. Eur Respir J 40:1324–1343

    Article  PubMed  Google Scholar 

  4. Tashkin DP, Celli B, Decramer M et al (2008) Bronchodilator responsiveness in patients with COPD. Eur Respir J 31:742–750

    Article  PubMed  CAS  Google Scholar 

  5. Lommatzsch M (2012) Airway hyperresponsiveness: new insights into the pathogenesis. Semin Respir Crit Care Med 33:579–587

    Article  PubMed  Google Scholar 

  6. Bougault V, Turmel J, Boulet LP (2010) Bronchial challenges and respiratory symptoms in elite swimmers and winter sport athletes: airway hyperresponsiveness in asthma: its measurement and clinical significance. Chest 138:31S-37S

    Article  PubMed  Google Scholar 

  7. o A (1998) Guidelines for bronchial provocation tests with pharmacologic agents. Pneumologie 52:214–220

    Google Scholar 

  8. Crapo RO, Casaburi R, Coates AL et al (2000) Guidelines for methacholine and exercise challenge testing. Am J Respir Crit Care Med 161:309–329

    Article  PubMed  CAS  Google Scholar 

  9. Merget R, Jorres RA, Heinze E et al (2009) Development of a 1-concentration-4-step dosimeter protocol for methacholine testing. Respir Med 103:607–613

    Article  PubMed  Google Scholar 

  10. Schulze J, Rosewich M, Riemer C et al (2009) Methacholine challenge – comparison of an ATS protocol to a new rapid single concentration technique. Respir Med 103:1898–1903

    Article  PubMed  Google Scholar 

  11. Barnes PJ, Dweik RA, Gelb AF et al (2010) Exhaled nitric oxide in pulmonary diseases: a comprehensive review. Chest 138:682–692

    Article  PubMed  CAS  Google Scholar 

  12. Dweik RA, Boggs PB, Erzurum SC et al (2011) An official ATS clinical practice guideline: interpretation of exhaled nitric oxide levels (FENO) for clinical applications. Am J Respir Crit Care Med 184:602–615

    Article  PubMed  CAS  Google Scholar 

  13. Powell H, Murphy VE, Taylor DR et al (2011) Management of asthma in pregnancy guided by measurement of fraction of exhaled nitric oxide: a double-blind, randomised controlled trial. Lancet 378:983–990

    Article  PubMed  CAS  Google Scholar 

  14. Haldar P, Brightling CE, Hargadon B et al (2009) Mepolizumab and exacerbations of refractory eosinophilic asthma. N Engl J Med 360:973–984

    Article  PubMed  CAS  Google Scholar 

  15. Pavord ID, Korn S, Howarth P et al (2012) Mepolizumab for severe eosinophilic asthma (DREAM): a multicentre, double-blind, placebo-controlled trial. Lancet 380:651–659

    Article  PubMed  CAS  Google Scholar 

  16. Kleine-Tebbe J, Ollert M, Jakob T (2010) Molekulare Allergologie – Teil 1: Nomenklatur, Proteinfamilien, Datenbanken und potenzieller Nutzen. Allergo J 19:390–394

    Google Scholar 

  17. Kleine-Tebbe J, Bufe A, Ebner C et al (2009) Die spezifische Immuntherapie (Hyposensibilisierung) bei IgE-vermittelten allergischen Erkrankungen. Allergo J 18:508–537

    Google Scholar 

  18. Petersen A (2009) Molekulare Allergologie: Was bringt die Kenntnis der Allergenstruktur für das Verständnis der Allergie und für die Verbesserung der Diagnostik und Therapie? Allergo J 18:551–555

    Google Scholar 

  19. Przybilla B, Rueff F, Walker A et al (2011) Diagnose und Therapie der Bienen- und Wespengiftallergie. Allergo J 20:318–339

    Google Scholar 

  20. Rackemann FM (1918) A clinical study of one hundred and fifty cases of bronchial asthma. Arch Intern Med 12:517–552

    Article  Google Scholar 

  21. Jia G, Erickson RW, Choy DF et al (2012) Periostin is a systemic biomarker of eosinophilic airway inflammation in asthmatic patients. J Allergy Clin Immunol 130:647–654

    Article  PubMed  CAS  Google Scholar 

  22. Lommatzsch M, Korn S, Buhl R, Virchow JC (2013) Against all odds: anti-IgE for intrinsic asthma? Thorax (im Druck)

Download references

Einhaltung ethischer Richtlinien

Interessenkonflikt. M. Lommatzsch gibt an, dass kein Interessenkonflikt besteht. Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

Author information

Authors and Affiliations

  1. Abteilung für Pneumologie und Internistische Intensivmedizin, Zentrum für Innere Medizin, Universitätsklinikum Rostock, Ernst-Heydemann-Str. 6, 18057, Rostock, Deutschland

    M. Lommatzsch

Authors
  1. M. Lommatzsch
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to M. Lommatzsch.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Lommatzsch, M. Aktuelles in der Asthmadiagnostik. Pneumologe 10, 394–399 (2013). https://doi.org/10.1007/s10405-013-0706-3

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10405-013-0706-3

Schlüsselwörter

Keywords

Search

Navigation