Smith L J, Shelhamer J H, Kaliner M
J Allergy Clin Immunol. 1980 Nov;66(5):374-8. doi: 10.1016/0091-6749(80)90116-5.
We studied the pupillary responses of various subjects to carbamylcholine chloride (CCC) in order to assess cholinergic responsiveness. Using the concentration of topical CCC required to induce greater than or equal to 1 mm miosis in the dark as the end point, we compared the responses of five groups of subjects: normal controls; patients with allergic asthma, allergic rhinitis, or intrinsic asthma; and a group who had reproducibly positive skin tests in the absence of symptoms. Subjects with allergic rhinitis or allergic asthma were significantly more sensitive than were normal controls. The patients with positive skin test and negative history were as sensitive as their symptomatic cohorts, suggesting that pupillary cholinergic hyperresponsiveness exists in atopic individuals regardless of symptoms. A small group with intrinsic asthma was examined and found to be even more sensitive than any of the atopic subjects. Thus abnormal hyperresponsiveness of the pupillary constrictor muscles to a topically instilled cholinomimetic has been found in all groups of atopic subjects plus nonallergic asthmatics. Analysis of pupillary responses may prove useful in assessment of autonomic responsiveness.
我们研究了不同受试者对氯化氨甲酰胆碱（CCC）的瞳孔反应，以评估胆碱能反应性。以在黑暗中诱导瞳孔缩小大于或等于1毫米所需的局部CCC浓度作为终点，我们比较了五组受试者的反应：正常对照组；患有过敏性哮喘、过敏性鼻炎或内源性哮喘的患者；以及一组皮肤试验呈阳性但无症状的受试者。患有过敏性鼻炎或过敏性哮喘的受试者比正常对照组明显更敏感。皮肤试验呈阳性且无病史的患者与其有症状的同类患者一样敏感，这表明特应性个体无论有无症状都存在瞳孔胆碱能反应过度。对一小组内源性哮喘患者进行了检查，发现他们比任何特应性受试者都更敏感。因此，在所有特应性受试者组以及非过敏性哮喘患者中，都发现瞳孔收缩肌对局部滴注的拟胆碱药存在异常的高反应性。瞳孔反应分析可能在评估自主神经反应性方面证明是有用的。
