Crescioli S, Spinazzi A, Plebani M, Pozzani M, Mapp C E, Boschetto P, Fabbri L M
Institute of Occupational Medicine, University of Padova, Italy.
Ann Allergy. 1991 Mar;66(3):245-51.
To determine whether oral slow-release theophylline inhibits asthmatic reactions and the associated increase of airway responsiveness to methacholine induced by allergens, we examined six asthmatic subjects who developed a dual asthmatic reactions after allergen bronchoprovocation with Dermatophagoides pteronyssinus or with grass pollen. We gave oral slow-release theophylline and placebo to each subject for seven days in two series of experiments in a double-blind, randomized, crossover study. The individual daily dose of theophylline (4.7 to 16.6 mg/kg/day, divided into two doses) was calculated for each subject by measuring individual theophylline clearance and optimal daily dosage. During treatment with placebo, the subjects developed dual asthmatic reactions, ie, FEV1 decreased from 4.1 +/- 0.17 L before bronchoprovocation to 3.2 +/- 0.14 L at 15 minutes and to 3.2 +/- 0.19 L at seven hours after allergen bronchoprovocation. By contrast, during active treatment FEV1 decreased from 4.2 +/- 0.28 L to 3.9 +/- 0.26 L at 15 minutes, and to 3.8 +/- 0.13 L at seven hours (both cases, P less than .03 compared with placebo). Mean serum theophylline concentration was 13.2 +/- 0.6 mg/L. Although 1 week's treatment with slow-release theophylline did not modify significantly either prechallenge airway responsiveness to methacholine or its increase after allergen inhalation challenge, in five out of six subjects theophylline significantly inhibited the increase of airway responsiveness to methacholine induced by allergens compared to placebo and control day (P less than .05). These results suggest that slow-release theophylline may inhibit allergen-induced asthmatic reactions and the associated increase of airway responsiveness, suggesting some antiinflammatory effects for this drug.
为了确定口服缓释茶碱是否能抑制哮喘反应以及由过敏原引起的气道对乙酰甲胆碱反应性的相关增加，我们检查了6名哮喘患者，这些患者在接受屋尘螨或草花粉过敏原支气管激发试验后出现了双重哮喘反应。在一项双盲、随机、交叉研究的两个系列实验中，我们给每位受试者口服缓释茶碱和安慰剂，为期7天。通过测量个体茶碱清除率和最佳日剂量，为每位受试者计算出茶碱的个体日剂量（4.7至16.6mg/kg/天，分两次服用）。在服用安慰剂期间，受试者出现了双重哮喘反应，即FEV1在支气管激发试验前为4.1±0.17L，在过敏原支气管激发试验后15分钟降至3.2±0.14L，7小时后降至3.2±0.19L。相比之下，在积极治疗期间，FEV1在15分钟时从4.2±0.28L降至3.9±0.26L，7小时后降至3.8±0.13L（两种情况与安慰剂相比，P均小于0.03）。平均血清茶碱浓度为13.2±0.6mg/L。尽管1周的缓释茶碱治疗并未显著改变激发前气道对乙酰甲胆碱的反应性或过敏原吸入激发后其增加情况，但与安慰剂和对照日相比，6名受试者中有5名受试者的茶碱显著抑制了过敏原诱导的气道对乙酰甲胆碱反应性的增加（P小于0.05）。这些结果表明，缓释茶碱可能抑制过敏原诱导的哮喘反应以及相关的气道反应性增加，提示该药物具有一定的抗炎作用。
