Fujimura M, Nishioka S, Kumabashiri I, Matsuda T, Mifune J
Third Department of Internal Medicine, Kanazawa, University School of Medicine, Japan.
Chest. 1990 Aug;98(2):276-9. doi: 10.1378/chest.98.2.276.
Bronchial hyperresponsiveness is one of the major clinical features of bronchial asthma. We previously reported that oral administration of a selective thromboxane synthetase inhibitor, OKY-046, reduced bronchial hyperresponsiveness to acetylcholine in asthmatic subjects. In this study, the effect of aerosol administration of OKY-046 on bronchial hyperresponsiveness was evaluated in ten inpatients with intrinsic asthma. Acetylcholine inhalation tests were performed before and after four days of inhalation of OKY-046 (100 mg/day). The provocative concentration of acetylcholine producing a 20 percent fall in forced expiratory volume in 1 s (PC20-FEV1) and that causing a 35 percent fall in respiratory conductance (PC35-Grs) were measured as indexes of bronchial responsiveness. There was a significant increase in PC20-FEV1 (p less than 0.001) and PC35-Grs (p less than 0.02) after inhalation of OKY-046 from 0.79 (GSEM, 1.41) Mg/ml and 0.96 (GSEM, 1.35) mg/ml to 1.20 (GSEM, 1.41) mg/ml and 1.74 (GSEM, 1.32) mg/ml, respectively. There was no significant difference in forced vital capacity (FVC), FEV1, or respiratory resistance (Rrs) baseline values before and after inhalation of OKY-046. Platelet aggregation was not inhibited by the treatment in other five inpatients. Thus, prophylactic administration of aerosol OKY-046 may be available for treatment of asthma by reduction of bronchial hyperresponsiveness. Further studies are needed to determine the optimum dose.
支气管高反应性是支气管哮喘的主要临床特征之一。我们之前报道过,口服一种选择性血栓素合成酶抑制剂OKY - 046可降低哮喘患者对乙酰胆碱的支气管高反应性。在本研究中,对10例内源性哮喘住院患者评估了雾化吸入OKY - 046对支气管高反应性的影响。在吸入OKY - 046(100毫克/天)4天前后进行乙酰胆碱吸入试验。将导致第1秒用力呼气量下降20%的乙酰胆碱激发浓度(PC20 - FEV1)和导致呼吸传导率下降35%的浓度(PC35 - Grs)作为支气管反应性指标进行测量。吸入OKY - 046后,PC20 - FEV1(p小于0.001)和PC35 - Grs(p小于0.02)显著增加,分别从0.79(几何标准误,1.41)微克/毫升和0.96(几何标准误,1.35)毫克/毫升增至1.20(几何标准误,1.41)毫克/毫升和1.74(几何标准误,1.32)毫克/毫升。吸入OKY - 046前后的用力肺活量(FVC)、FEV1或呼吸阻力(Rrs)基线值无显著差异。在其他5例住院患者中,该治疗未抑制血小板聚集。因此,预防性雾化吸入OKY - 046可能通过降低支气管高反应性来治疗哮喘。需要进一步研究以确定最佳剂量。