Effects of histamine and reproterol inhalation on mouth occlusion pressure in patients with bronchial asthma.

Both vagal and non-vagal afferences from the lung or chest wall contribute to increasing neural drive to the respiratory muscles, but only the former are known to change the breathing pattern by increasing respiratory frequency (RF) during bronchoconstriction. In order to evaluate the relative contribution of vagal and non-vagal afferences to increasing neural drive to the respiratory muscles in 14 asymptomatic asthmatic patients known to be responsive (decrease in FEV1 greater than 20% of the control values) to previous bronchial provocation test (BPT) with aerosolized histamine, we evaluated FEV1, breathing pattern and neuromuscular drive, as assessed by mouth occlusion pressure (PO.1), under control conditions, during BPT with progressive doubling doses of inhaled histamine (H) and 5 min after inhalation of a bronchodilator agent (Reproterol) (B). During HBPT FEV1 exhibited a significant decrease (p less than 0.01) while PO.1 was found to increase significantly (p less than 0.01). However, no significant changes were noted in breathing pattern. After B FEV1 returned to control values while PO.1, even if significantly reduced (p less than 0.01), did not. Changes in PO.1 were found to be significantly related to changes in FEV1 both during HBPT and B (p less than 0.05). The data suggest that in these patients non-vagal afferences, linked to the abnormalities of thoraco-pulmonary mechanics, could play a major role in changing neural drive to the respiratory muscles.