Freitag A, Watson R M, Matsos G, Eastwood C, O'Byrne P M
Department of Medicine, McMaster University, Hamilton, Ontario, Canada.
Thorax. 1993 Jun;48(6):594-8. doi: 10.1136/thx.48.6.594.
Platelet activating factor (PAF) has been implicated in the pathogenesis of airway hyperresponsiveness in asthma. The purpose of this study was to evaluate the effects of a selective PAF antagonist (WEB 2086), given in doses known to antagonise the effects of inhaled PAF in human subjects, on allergen induced early and late asthmatic responses and on airway hyperresponsiveness.
Eight atopic, mildly asthmatic subjects were studied during a screening period and two treatment periods. During the screening period subjects inhaled an allergen to which they were known to be sensitised and the response was measured as the fall in the forced expired volume in one second (FEV1) to show the presence of early (0-1 h) and late (3-7 h) asthmatic responses. On another day the subjects inhaled allergen diluent. During the treatment periods subjects inhaled allergen after one week's pretreatment with WEB 2086 (100 mg three times a day) or placebo administered in a randomised, double blind, crossover fashion. Histamine airway responsiveness was measured 24 hours before and 24 hours after allergen and the results were expressed as the provocative concentration causing a 20% fall in FEV1 (PC20).
The maximal early asthmatic response after allergen with placebo treatment was 18.4% (SE 4.4%) and with WEB 2086 18.9% (4.4%). The maximal late response with placebo treatment was 21.7% (5.3%) and with WEB 2086 21.2% (3.0%). The log difference (before and after allergen) in histamine PC20 was 0.35 (0.06) after placebo treatment and 0.30 (0.1) after WEB 2086.
These results indicate that one week of treatment with an orally administered PAF antagonist (WEB 2086) does not attenuate allergen induced early or late responses or airway hyperresponsiveness.
血小板活化因子(PAF)与哮喘气道高反应性的发病机制有关。本研究的目的是评估一种选择性PAF拮抗剂(WEB 2086)对变应原诱导的哮喘早期和晚期反应以及气道高反应性的影响,其给药剂量已知可拮抗吸入PAF对人体的作用。
对8名特应性轻度哮喘患者在筛查期和两个治疗期进行研究。在筛查期,患者吸入已知对其致敏的变应原,并以一秒用力呼气容积(FEV1)下降来衡量反应,以显示早期(0 - 1小时)和晚期(3 - 7小时)哮喘反应的存在。在另一天,患者吸入变应原稀释剂。在治疗期,患者在接受一周的WEB 2086(100毫克,每日三次)或安慰剂预处理后,以随机、双盲、交叉方式吸入变应原。在变应原前后24小时测量组胺气道反应性,结果以引起FEV1下降20%的激发浓度(PC20)表示。
安慰剂治疗后变应原激发后的最大早期哮喘反应为18.4%(标准误4.4%),WEB 2086治疗后为18.9%(4.4%)。安慰剂治疗后的最大晚期反应为21.7%(5.3%),WEB 2086治疗后为21.2%(3.0%)。安慰剂治疗后组胺PC20(变应原前后)的对数差值为0.35(0.06),WEB 2086治疗后为0.30(0.1)。
这些结果表明,口服PAF拮抗剂(WEB 2086)治疗一周并不能减轻变应原诱导的早期或晚期反应或气道高反应性。