Mapp C, Boschetto P, dal Vecchio L, Crescioli S, de Marzo N, Paleari D, Fabbri L M
Institute of Occupational Medicine, University of Padova, Italy.
Am Rev Respir Dis. 1987 Dec;136(6):1403-7. doi: 10.1164/ajrccm/136.6.1403.
To determine whether 4 drugs used in the treatment of asthma inhibit the late asthmatic reaction and the associated increase in airway responsiveness induced by toluene diisocyanate (TDI), we studied 24 sensitized subjects divided into 4 groups. Beclomethasone aerosol (1 mg bid), slow-release theophylline (6.5 mg/kg bid), slow-release verapamil (120 mg bid), and cromolyn (20 mg qid via spinhaler), were administered for 7 days, respectively, to 1 of the 4 groups, according to a double-blind, crossover, placebo-controlled study design. When the subjects were treated with placebo, verapamil, or cromolyn, FEV1 markedly decreased and airway responsiveness increased after exposure to TDI. By contrast, beclomethasone prevented the late asthmatic reaction and the associated increase in airway responsiveness to methacholine induced by TDI. Slow-release theophylline partially inhibited both the immediate and the late asthmatic reactions but had no effect on airway hyperresponsiveness to methacholine. These results suggest that only high-dose inhaled steroids can completely block TDI-induced late asthmatic reactions.
为了确定用于治疗哮喘的4种药物是否能抑制迟发性哮喘反应以及由甲苯二异氰酸酯（TDI）诱发的气道反应性增加，我们研究了24名致敏受试者，将其分为4组。根据双盲、交叉、安慰剂对照研究设计，分别给4组中的1组受试者使用倍氯米松气雾剂（每日2次，每次1 mg）、缓释茶碱（每日2次，每次6.5 mg/kg）、缓释维拉帕米（每日2次，每次120 mg）和色甘酸钠（通过旋转吸入器每日4次，每次20 mg），持续7天。当受试者接受安慰剂、维拉帕米或色甘酸钠治疗时，暴露于TDI后FEV1显著下降，气道反应性增加。相比之下，倍氯米松可预防迟发性哮喘反应以及TDI诱发的对乙酰甲胆碱气道反应性增加。缓释茶碱部分抑制速发性和迟发性哮喘反应，但对乙酰甲胆碱诱导的气道高反应性无影响。这些结果表明，只有高剂量吸入性类固醇能完全阻断TDI诱发的迟发性哮喘反应。
