哮喘联盟

   摘要
   背景：气道高反应性是哮喘的一个主要特征。虽然胆碱能神经效应器传递的调节可能在气道反应性中发挥作用，但是体内的证据依然缺乏。众所周知组胺可以通过迷走神经反射导致部分支气管收缩，但是乙酰甲胆碱不能。为了研究调节神经效应传递的意义，本研究比较了低剂量β2肾上腺素受体激动剂沙丁胺醇抑制组胺与乙酰甲胆碱介导的气道反应性作用。
   方法：本研究共纳入了12例稳定期哮喘受试者。在该项随机交叉试验中，经筛选证实吸入低剂量沙丁胺醇(1μg)不会改变其基础肺功能后，受试者无论是否接受低剂量沙丁胺醇预先治疗，均吸入组胺和乙酰甲胆碱，通过呼吸道过敏性测定仪测定气道反应性，并在持续吸入浓度逐步递增的组胺或乙酰甲胆碱期间，通过受迫振荡方法来评估呼吸传导率(Grs)。以诱导Grs下降35%的支气管扩张药物累积剂量计算气道反应性。
   结果：吸入1μg沙丁胺醇显著减弱患者对组胺而非乙酰甲胆碱的气道反应性。无论疾病严重程度或表型（即特异性或非特异性）如何，都可观察到该选择性的弱化作用。
   结论：哮喘患者，低剂量沙丁胺醇抑制哮喘患者对组胺而非乙酰甲胆碱的气道反应性。本研究为临床机构中β2-受体激动剂的气道保护机制提供了新见解。
 

（林江涛 审校）
Respir Investig. 2013 Sep;51(3):158-65. doi: 10.1016/j.resinv.2013.03.001. Epub 2013 May 7.

 

Low-dose salbutamol suppresses airway responsiveness to histamine but not methacholine in subjects with asthma.
 

Matsumoto K, Aizawa H, Fukuyama S, Yoshida M, Komori M, Takata S, Koto H, Inoue H.
 

Abstract
BACKGROUND:Airway hyperresponsiveness is a cardinal feature of asthma. Although the modulation of cholinergic neuroeffector transmission may play a role in airway responsiveness, in vivo evidence remains scarce. It is well known that histamine causes bronchoconstriction partly via vagal reflex, whereas methacholine does not. To investigate the significance of modulating neuroeffector transmission, we compared the effect of low-dose salbutamol-a β2-adrenoceptor agonist-on airway responsiveness to histamine with that to methacholine.
METHODS:We enrolled 12 subjects with stable asthma. After screening confirmed that inhalation of low-dose salbutamol (1μg) did not change their basic pulmonary function, subjects underwent measurement of airway responsiveness to inhaled histamine and methacholine with or without pretreatment with low-dose salbutamol, in a randomized, crossover fashion. Airway responsiveness was measured by an astograph by which respiratory conductance (Grs) was assessed by the forced oscillation method during continuous inhalation of histamine or methacholine in stepwise incremental concentrations. Airway responsiveness was calculated as the cumulative dose of bronchoconstrictors that induced a decrease of 35% in Grs.
RESULTS:Inhalation of 1μg of salbutamol significantly attenuated airway responsiveness to histamine but not methacholine. This selective attenuation was observed irrespective of disease severity or phenotype, namely atopy or non-atopy.
CONCLUSION:Low-dose salbutamol suppresses airway responsiveness to histamine but not methacholine in subjects with asthma. The present study may provide a novel insight into the bronchoprotective mechanism of β2-adorenoceptor agonist in clinical settings.
 

Respir Investig. 2013 Sep;51(3):158-65. doi: 10.1016/j.resinv.2013.03.001. Epub 2013 May 7.