Hulks G, Jardine A G, Connell J M, Thomson N C
Department of Respiratory Medicine, Western Infirmary, Glasgow, United Kingdom.
Am Rev Respir Dis. 1991 Apr;143(4 Pt 1):778-82. doi: 10.1164/ajrccm/143.4_Pt_1.778.
Recent studies have demonstrated that elevation of plasma atrial natriuretic factor (ANF) levels may produce significant bronchodilation in the constricted asthmatic airway. The current study was designed to examine the effect of both physiologic and pharmacologic plasma levels of ANF on bronchial reactivity to histamine in asthmatic subjects. A total of eight atopic men with well-controlled asthma were studied, mean (SD) FEV1 3.50 (0.73) L, equivalent to 87 (11)% of predicted; bronchial reactivity as measured by histamine PC20 was 0.77 mg/ml (geometric mean). On four separate study days infusions of 1, 3, or 10 pmol/kg/min of ANF or placebo were administered in a double-blind, randomized manner. Once steady-state plasma levels had been achieved, measurement of bronchial reactivity was repeated. Mean (SEM) basal ANF level was 18.5 (3.5) pg/ml and rose to 41 (4.3), 157 (15), and 500 (30) pg/ml with increasing doses of ANF. With placebo infusion geometric mean histamine PC20 was 0.77 mg/ml and rose to 1.15 mg/ml (p less than 0.05), 1.90 mg/ml (p less than 0.001), and 3.38 mg/ml (p less than 0.001), corresponding to a 1.5-, 2.5-, and 4.4-fold protection with respective ANF infusions. There was no significant change in plasma epinephrine. These results show that at both physiologic and pathophysiologic plasma levels ANF may significantly decrease bronchial reactivity to histamine in asthma.
近期研究表明，血浆心房利钠因子（ANF）水平升高可能会使收缩的哮喘气道产生显著的支气管扩张。本研究旨在探讨生理和药理血浆水平的ANF对哮喘患者支气管对组胺反应性的影响。共研究了8名哮喘控制良好的特应性男性，平均（标准差）第一秒用力呼气容积（FEV1）为3.50（0.73）L，相当于预测值的87（11）%；通过组胺PC20测定的支气管反应性为0.77 mg/ml（几何均值）。在四个不同的研究日，以双盲、随机的方式输注1、3或10 pmol/kg/min的ANF或安慰剂。一旦达到稳态血浆水平，便重复测量支气管反应性。基础ANF水平平均（标准误）为18.5（3.5）pg/ml，随着ANF剂量增加分别升至41（4.3）、157（15）和500（30）pg/ml。输注安慰剂时，组胺PC20几何均值为0.77 mg/ml，分别升至1.15 mg/ml（p<0.05）、1.90 mg/ml（p<0.001）和3.38 mg/ml（p<0.001），相应地，输注不同剂量ANF时分别有1.5倍、2.5倍和4.4倍的保护作用。血浆肾上腺素无显著变化。这些结果表明，在生理和病理生理血浆水平下，ANF均可显著降低哮喘患者支气管对组胺的反应性。
