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Rebuttal From Drs Pellegrino and BrusascoRebuttal From Drs Pellegrino and Brusasco

Riccardo Pellegrino, MD; Vito Brusasco, MD
Author and Funding Information

From the Allergologia e Fisiopatologia Respiratoria (Dr Pellegrino) and Dipartimento di Medicina Interna e Specialità Mediche (Dr Brusasco), Scuola di Scienze Mediche e Farmaceutiche, Università di Genova.

CORRESPONDENCE TO: Riccardo Pellegrino, MD, Allergologia and Fisiopatologia Respiratoria, ASO S Croce e Carle, 12100 Cuneo, Italy; e-mail: pellegrino.r@ospedale.cuneo.it


FINANCIAL/NONFINANCIAL DISCLOSURES: The authors have reported to CHEST that no potential conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2014;146(3):541-542. doi:10.1378/chest.14-0811
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Extract

There are major reasons for testing acute bronchoreversibility in clinical practice. For instance, finding large increments in FEV1 > 400 mL is of great value to confirm the diagnosis of asthma and support therapy. Evaluating whether airflow obstruction is still reversible is also important, even though normal acute responses do not predict effects of chronic treatment and in no case preclude trials with bronchoactive medications. Drs Hansen and Porszasz1 suggest that with respect to the American Thoracic Society/European Respiratory Society (ATS/ERS) guidelines,2 the perceptive threshold is more suitable for evaluating bronchoreversibility. We will try to convince our readers that exploring lung mechanics with various functional parameters capable of identifying the fundamental and complex changes with bronchodilation is more important than debating the concept of threshold.

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