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单剂量选择素抑制剂TBC1269对哮喘早期和晚期反应的影响。

Effect of a single dose of the selectin inhibitor TBC1269 on early and late asthmatic responses.

作者信息

Avila P C, Boushey H A, Wong H, Grundland H, Liu J, Fahy J V

机构信息

Department of Medicine and Cardiovascular Research Institute, University of California at San Francisco, San Francisco, CA 94143-0130, USA.

出版信息

Clin Exp Allergy. 2004 Jan;34(1):77-84. doi: 10.1111/j.1365-2222.2004.01831.x.

Abstract

BACKGROUND

Selectins participate in the initial phase of leucocyte migration from circulation to inflamed tissues and may play a role in inflammatory cellular influx into airways in asthma. In the sheep asthma model, TBC1269, a pan-selectin antagonist, reduced late allergen response by 74%.

OBJECTIVE

To determine whether a single dose of TBC1269 inhibits early (EAR) and late (LAR) asthmatic responses, and whether it inhibits sputum leucocyte influx after inhalation allergen challenge in atopic asthmatic subjects treated with bronchodilators only.

METHODS

Twenty-one asthmatic subjects (mean+/-SD, age=32.5+/-6.7 years, 8 males, FEV1 percent predicted=84+/-15%) with known late asthmatic response based on a screening inhalation allergen challenge were randomly assigned to receive intravenous treatment with either placebo (n=11) or TBC1269 (n=10, 30 mg/kg) infused over 15 min immediately prior to a second (post-treatment) allergen challenge at least 4 weeks after the screening challenge. After each challenge, EAR and LAR were monitored for 7 h. In addition, sputum was induced 1 day before and 1 day after each allergen challenge.

RESULTS

TBC1269 did not attenuate the EAR compared with placebo (largest fall in FEV1 within 1 h of 34.1+/-13.9% vs. 31.8+/-12.2% for TBC1269 and placebo groups respectively, P=0.61) or the LAR (largest fall in FEV1 between 3 and 7 h of 39.3+/-15.3% vs. 32.6+/-13.8%, P=0.24). TBC1269 had only minor effects on allergen-induced sputum eosinophilia.

CONCLUSION

We conclude that TBC1269 administered before allergen challenge as a single intravenous dose does not attenuate early or late asthmatic responses to allergen in asthmatic subjects.

摘要

背景

选择素参与白细胞从循环系统迁移至炎症组织的初始阶段,可能在哮喘患者气道炎症细胞浸润中发挥作用。在绵羊哮喘模型中,泛选择素拮抗剂TBC1269使迟发性变应原反应降低了74%。

目的

确定单次剂量的TBC1269是否能抑制特应性哮喘患者在仅接受支气管扩张剂治疗时,吸入变应原激发后的早期(EAR)和晚期(LAR)哮喘反应,以及是否能抑制痰液白细胞浸润。

方法

21名已知基于筛查吸入变应原激发试验存在迟发性哮喘反应的哮喘患者(平均±标准差,年龄=32.5±6.7岁,8名男性,预计FEV1百分比=84±15%),在筛查激发试验至少4周后,于第二次(治疗后)变应原激发试验前15分钟,随机分配接受静脉注射安慰剂(n=11)或TBC1269(n=10,30mg/kg)治疗。每次激发试验后,监测EAR和LAR 7小时。此外,在每次变应原激发试验前1天和后1天诱导痰液。

结果

与安慰剂相比,TBC1269并未减轻EAR(TBC1269组和安慰剂组在1小时内FEV1的最大下降分别为34.1±13.9%和31.8±12.2%,P=0.61)或LAR(在3至7小时内FEV1的最大下降分别为39.3±15.3%和32.6±13.8%,P=0.24)。TBC1269对变应原诱导的痰液嗜酸性粒细胞增多仅有轻微影响。

结论

我们得出结论,在变应原激发试验前单次静脉注射TBC1269并不能减轻哮喘患者对变应原的早期或晚期哮喘反应。

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