Nakano Jinichi, Yano Tomoko, Yamamura Koichi, Yoshihara Hisanao, Ohbayashi Oji, Yamashita Naomi, Ohta Ken
Department of Medicine, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo, Japan.
Respir Med. 2006 Mar;100(3):542-50. doi: 10.1016/j.rmed.2005.05.023. Epub 2005 Dec 6.
The control of airway inflammation is crucial for management of asthma. Theophylline has been demonstrated to have an anti-inflammatory effect as a long-term-medication for asthma in various studies. In the present study we attempted to clarify if aminophylline, a theophylline derivative, could act as an anti-inflammatory agent as well as a bronchodilator in the treatment for acute asthma exacerbations.
Patients are initially treated either with an intravenous infusion of aminophylline or with inhalation of salbutamol. Pro-inflammatory mediators such as eosinophil cationic protein (ECP), histamine, serotonin, thromboxane B2, leukotriene C4 were measured before and one hour after the initial treatment. Clinical parameters such as peak expiratory flow (PEF) and SpO2 were also checked during the studies.
Significant improvements of PEF and SpO2 with both aminophylline and salbutamol treatment were seen. Furthermore, significant decreases of ECP, histamine, and serotonin were observed with aminophylline but not with salbutamol.
Suppressing the release of pro-inflammatory mediators may play a role, at least in part, in the beneficial effects of aminophylline in the treatment of acute exacerbations in asthma. Additionally, this study indicated that treatment with aminophylline is at least as beneficial as nebulized salbutamol in the restoration of lung function.
气道炎症的控制对哮喘管理至关重要。在多项研究中，已证明茶碱作为哮喘的长期治疗药物具有抗炎作用。在本研究中，我们试图阐明氨茶碱（一种茶碱衍生物）在治疗急性哮喘发作时是否能作为抗炎剂以及支气管扩张剂发挥作用。
患者最初接受氨茶碱静脉输注或沙丁胺醇吸入治疗。在初始治疗前及治疗后1小时测量促炎介质，如嗜酸性粒细胞阳离子蛋白（ECP）、组胺、5-羟色胺、血栓素B2、白三烯C4。在研究过程中还检查了临床参数，如呼气峰值流速（PEF）和血氧饱和度（SpO2）。
氨茶碱和沙丁胺醇治疗后PEF和SpO2均有显著改善。此外，氨茶碱治疗后ECP、组胺和5-羟色胺显著降低，而沙丁胺醇治疗后未出现这种情况。
抑制促炎介质的释放可能至少在一定程度上发挥了氨茶碱治疗哮喘急性发作的有益作用。此外，本研究表明氨茶碱治疗在恢复肺功能方面至少与雾化沙丁胺醇一样有益。
