O'Connor B J, Crowther S D, Costello J F, Morley J
Sackler Institute of Pulmonary Pharmacology, Department of Respiratory Medicine, King's College Hospital, Denmark Hill, London, UK.
Trends Pharmacol Sci. 1999 Jan;20(1):9-11. doi: 10.1016/s0165-6147(98)01280-2.
Hyperresponsiveness of airway smooth muscle accounts for the susceptibility of asthmatic subjects to diverse bronchoconstrictor agents. It is widely presumed that hyperresponsiveness is not spasmogen selective. Hence, inhalation of methacholine is used routinely for clinical assessment of asthma and for evaluation of anti-asthma drugs. Comparative studies employing multiple spasmogens have revealed hyperresponsiveness to be markedly spasmogen selective. Because of this pronounced heterogeneity of hyperresponsiveness, sensitivity to methacholine cannot provide a reliable index of responsiveness. Development of exceptional hyperresponsiveness to bradykinin and to peptidoleukotrienes during allergic and other reactions could warrant the development of specific antagonists for asthma therapy. These issues are discussed here by Brian O'Connor, Simon Crowther, John Costello and John Morley.
气道平滑肌的高反应性是哮喘患者对多种支气管收缩剂敏感的原因。人们普遍认为高反应性并非对致痉剂具有选择性。因此，临床上常规使用吸入乙酰甲胆碱来评估哮喘以及评价抗哮喘药物。采用多种致痉剂的对比研究表明，高反应性对致痉剂具有显著的选择性。由于高反应性存在这种明显的异质性，对乙酰甲胆碱的敏感性无法提供可靠的反应性指标。在过敏反应和其他反应期间对缓激肽和肽白三烯产生异常高反应性，可能有必要研发用于哮喘治疗的特异性拮抗剂。Brian O'Connor、Simon Crowther、John Costello和John Morley在此对这些问题进行了讨论。
