Airways are More Reactive to Histamine than to Methacholine in Patients with Mild Airway Hyperresponsiveness, Regardless of Atopy
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Background : The airway muscles from allergen-sensitized animals in vitro show a heightened response to histamine, but not to carbachol. This study investigated whether the airway responsiveness to histamine in vivo is comparable to that of methacholine in human subjects with varying degrees of atopy. Methods : One-hundred-and-sixty-eight consecutive adult asthma patients or volunteers underwent bronchoprovocation tests to both histamine and methacholine after determining their blood eosinophil counts, serum total IgE levels and skin test reactivity to 10 common aeroallergens. Results : The responsiveness to histamine was significantly related to that to methacholine (r=0.609, p<0.001), but many individuals with a negative methacholine test response showed a positive response to histamine. The histamine-bronchial reactivity index (BRindex) was significantly higher than the methacholine-BRindex in subjects with a positive response to none (n=69, p<0.01) or only one (n=42, p<0.001) of histamine and methacholine, while there was no significant difference in the subjects with positive responses to both of them (n=57). The histamine-BRindex was significantly higher than the methacholine-BRindex in the subjects with mild histamine hyperresponsiveness (n=58, 1.28±0.01 vs. 1.20±0.02, respectively, p<0.001). Both histamine and methacholine responsiveness was significantly related to the atopy markers. However, the histamine-BRindex/methacholine-BRindex ratio of the atopics was not significantly different from that of the non-atopics. Conclusions : The airway responsiveness to histamine is comparable to that of methacholine in the subjects with positive responses to both histamine and methacholine, but the airway responsiveness to histamine is greater than that to methacholine in those subjects with mild airway hyperresponsiveness, regardless of atopy.
Abstract
Background : The airway muscles from allergen-sensitized animals in vitro show a heightened response to histamine, but not to carbachol. This study investigated whether the airway responsiveness to histamine in vivo is comparable to that of methacholine in human subjects with varying degrees of atopy. Methods : One-hundred-and-sixty-eight consecutive adult asthma patients or volunteers underwent bronchoprovocation tests to both histamine and methacholine after determining their blood eosinophil counts, serum total IgE levels and skin test reactivity to 10 common aeroallergens. Results : The responsiveness to histamine was significantly related to that to methacholine (r=0.609, p<0.001), but many individuals with a negative methacholine test response showed a positive response to histamine. The histamine-bronchial reactivity index (BRindex) was significantly higher than the methacholine-BRindex in subjects with a positive response to none (n=69, p<0.01) or only one (n=42, p<0.001) of histamine and methacholine, while there was no significant difference in the subjects with positive responses to both of them (n=57). The histamine-BRindex was significantly higher than the methacholine-BRindex in the subjects with mild histamine hyperresponsiveness (n=58, 1.28±0.01 vs. 1.20±0.02, respectively, p<0.001). Both histamine and methacholine responsiveness was significantly related to the atopy markers. However, the histamine-BRindex/methacholine-BRindex ratio of the atopics was not significantly different from that of the non-atopics. Conclusions : The airway responsiveness to histamine is comparable to that of methacholine in the subjects with positive responses to both histamine and methacholine, but the airway responsiveness to histamine is greater than that to methacholine in those subjects with mild airway hyperresponsiveness, regardless of atopy.
참고문헌 (23)
- Demoly P, "In vivo methods for study of allergy", pp.631~643 (2003), Philadelphia, Mosby
- Wasserman SI, "Approach to the patient with allergic or immunologic disease", pp.1590~1593 (2004), Philadelphia, Saunders
- Global Initiative for Asthma, "Global strategy for asthma management and prevention", pp.19~ (2006)
- O'Byrne PM, "Airway hyperresponsiveness", pp.859~866 (1998), Philadelphia, Mosby
- "Mechanical alterations of airway smooth muscle in a canine asthmatic model", 46, pp.681~687 (1979)
- "Histamine pharmacology in airway smooth muscle from a canine model of asthma", 213, pp.150~155 (1980)
- "Cysteinyl leukotrienes mediate histamine hypersensitivity ex vivo by increasing histamine receptor numbers", 5, pp.685~692 (1999)
- "Reproducibility and comparison of responses to inhaled histamine and methacholine", 33, pp.705~710 (1978)
- "Immediate skin test reactivity to food and drug administration approved standardized extracts", 86, pp.766~774 (1990)
- "standardized challenge testing with pharmacological physical and sensitizing stimuli in adults", pp.16 53~83 (1993)
- "a manual of uniform laboratory procedures" (1984)
- "Relationships of bronchial responsiveness assessed by methacholine to serum IgE and diagnoses in 11-year-old New Zealand children", pp.376~385 (1992)
- "Characteristics of bronchial hyperresponsiveness in chronic obstructive pulmonary disease and in asthma", 143, pp.1438~1443 (1991)
- "Airway responsiveness", pp.1253~1266 (1997), Philadelphia, Lippincott Raven
- "A comparison of methacholine and histamine inhalations in asthmatics", 56, pp.308~316 (1975)
- "Allergen- induced increase in non-allergic bronchial reactivity", 7, pp.503~513 (1977)
- "Mast cell tryptase potentiates histamine-induced contraction in human sensitized bronchus", 10, pp.38~43 (1997)
- "Sensitization alters contractile responses and calcium influx in human airway smooth muscle", 84, pp.440~447 (1989)
- "Relation between airway responsiveness and serum IgE in children with asthma and in apparently normal children", 325, pp.1067~1071 (1991)
- "Atopy in childhood relationship to airway responsiveness", pp.949~956 (1993)
- "The role of histamine and its receptors in the pathogenesis of asthma", 77, pp.215~226 (1983)
- "Autoradiographic localization of autonomic receptors in airway smooth muscle", 127, pp.758~762 (1983)
- "Tachyphylaxis to inhaled histamine in asthmatic subjects", 63, pp.1572~1577 (1987)