Stelmach I, Jerzyńska J, Bobrowska M, Brzozowska A, Majak P, Kuna P
Samodzielny Oddział Kliniczny Interny Dzieciecej i Alergologii IP AM w Łodzi.
Pol Arch Med Wewn. 2001 Jul;106(1):567-72.
Atopic asthma is a chronic inflammatory disorder of the airways associated with airway hyperresponsiveness to various bronchoconstrictor stimuli. There are several pharmacologic agents, involved in the inflammatory process, that can produce acute bronchoconstriction, such as metacholine. Heparin possesses multiple noncoagulant properties, including anti-inflammatory actions.
The purpose of the present study was to investigate the effect of inhaled heparin on the airway response to metacholine in children with asthma.
Fifteen children with mild atopic asthma participated in the study. It was randomized, double-blind, cross-over, placebo controlled study. There were three study visits. At the first visit patients were included into the study and beta-agonists were withheld for at least 12 hours before the next visit (second day). At the second visit provocation test with metacholine, inhalation with single dose of heparin or placebo followed by provocation test with metacholine were performed. After two weeks, tests were performed in the same manner except of that patients instead of heparin inhaled placebo or opposite.
Fourteen children completed the study. Single dose of inhaled heparin significantly decreased bronchial hyperresponsiveness to metacholine when compared to placebo.
The exact mechanism of anti-inflammatory role of heparin is still under investigation and needs to be studied further. The possible anti-inflammatory effect of heparin can be through effect on the neuronal M2 receptors or on receptor-protein G binding or direct effect on the smooth muscles, and in such mechanisms, heparin can decrease bronchial hyperreactivity to metacholine.
特应性哮喘是一种气道慢性炎症性疾病，与气道对各种支气管收缩刺激的高反应性相关。有几种参与炎症过程的药物制剂可引发急性支气管收缩，如乙酰甲胆碱。肝素具有多种非凝血特性，包括抗炎作用。
本研究旨在探讨吸入肝素对哮喘儿童气道对乙酰甲胆碱反应的影响。
15名轻度特应性哮喘儿童参与了本研究。这是一项随机、双盲、交叉、安慰剂对照研究。共有三次研究访视。在第一次访视时，患者被纳入研究，在下一次访视（第二天）前至少12小时停用β受体激动剂。在第二次访视时，先进行乙酰甲胆碱激发试验，然后吸入单剂量肝素或安慰剂，之后再进行乙酰甲胆碱激发试验。两周后，以相同方式进行测试，只是患者吸入的是安慰剂而非肝素，或者相反。
14名儿童完成了研究。与安慰剂相比，单剂量吸入肝素可显著降低气道对乙酰甲胆碱的高反应性。
肝素抗炎作用的确切机制仍在研究中，有待进一步深入探究。肝素可能的抗炎作用可能是通过作用于神经元M2受体、受体 - 蛋白G结合或直接作用于平滑肌，在这些机制中，肝素可降低气道对乙酰甲胆碱的高反应性。
