Mackay A D, Baldwin C J, Tattersfield A E
Am Rev Respir Dis. 1983 May;127(5):609-13. doi: 10.1164/arrd.1983.127.5.609.
The changes in airway caliber and plasma cyclic-AMP levels after intravenously administered aminophylline, and the effect of DL- and D-propranolol on these responses have been investigated in a double-blind manner in normal subjects. Aminophylline 5.6 mg/kg was given intravenously over a 10-min period and the airway response was measured as change in specific airway conductance (delta SGaw) in the body plethysmograph. In the initial study in 6 subjects, orally administered placebo or propranolol was followed 2 h later by intravenously administered aminophylline. Neither placebo nor propranolol alone caused any change in SGaw at 2 h. After placebo, intravenously injected aminophylline produced a 30% increase in SGaw, reaching a peak 5 min after injection. This response was equivalent to 77% of the maximal response to 400 micrograms inhaled albuterol in the same subjects. After propranolol, the airway response to aminophylline was attenuated, with a 53% reduction in delta SGaw at the time of peak response. In a further study on 6 subjects, intravenously given aminophylline produced a 25% increase in SGaw and a 51% increase in plasma cyclic-AMP levels after placebo tablets. Pretreatment with 40 and 80 mg DL-propranolol caused a dose-dependent reduction of both the airway and plasma cyclic-AMP response to aminophylline. The airway response to aminophylline was not attenuated by D-propranolol so the effect of DL-propranolol is thought to be due to beta-adrenoceptor blockade. The absence of any detectable change in SGaw after DL-propranolol suggests there is little resting sympathetic tone to the airways in normal subjects. In the absence of sympathetic stimulation, the rapid response to aminophylline is unlikely to be due to phosphodiesterase inhibition. The attenuation of the airway and cyclic-AMP response by propranolol suggests that part of the action of aminophylline may be due to beta-agonist activity.
在正常受试者中,以双盲方式研究了静脉注射氨茶碱后气道口径和血浆环磷酸腺苷(cAMP)水平的变化,以及DL-和D-普萘洛尔对这些反应的影响。在10分钟内静脉给予氨茶碱5.6mg/kg,并在体容积描记仪中测量气道反应,以比气道传导率(δSGaw)的变化来表示。在最初对6名受试者的研究中,口服安慰剂或普萘洛尔,2小时后静脉注射氨茶碱。安慰剂和普萘洛尔单独使用在2小时时均未引起SGaw的任何变化。给予安慰剂后,静脉注射氨茶碱使SGaw增加30%,注射后5分钟达到峰值。该反应相当于同一受试者吸入400μg沙丁胺醇最大反应的77%。给予普萘洛尔后,气道对氨茶碱的反应减弱,峰值反应时δSGaw降低53%。在对另外6名受试者的进一步研究中,安慰剂片剂后静脉给予氨茶碱使SGaw增加25%,血浆cAMP水平增加51%。用40mg和80mg DL-普萘洛尔预处理导致气道和血浆对氨茶碱的cAMP反应呈剂量依赖性降低。D-普萘洛尔未减弱气道对氨茶碱的反应,因此认为DL-普萘洛尔的作用是由于β-肾上腺素能受体阻滞。DL-普萘洛尔后SGaw未出现任何可检测到的变化,提示正常受试者气道几乎没有静息交感神经张力。在没有交感神经刺激的情况下,对氨茶碱的快速反应不太可能是由于磷酸二酯酶抑制。普萘洛尔对气道和环磷酸腺苷反应的减弱表明,氨茶碱的部分作用可能是由于β-激动剂活性。