Robuschi M, Gambaro G, Sestini P, Pieroni M G, Refini R M, Vaghi A, Bianco S
Institute of Respiratory Diseases, University of Milan, Italy.
Am J Respir Crit Care Med. 1997 Apr;155(4):1461-4. doi: 10.1164/ajrccm.155.4.9105094.
The protective activity of nedocromil sodium and of sodium cromoglycate against aspirin-induced asthma has never been investigated in controlled studies. Because it has been reported that aspirin-induced platelet-mediated cytotoxic activity in vitro is inhibited after treatment in vivo with nedocromil but not with cromoglycate, we investigated whether these compounds also exhibit a different protective activity against aspirin-induced bronchoconstriction. Ten patients with aspirin-induced asthma underwent three bronchial challenges with a single dose of lysine acetylsalicylate (LASA) that caused a decrease in FEV1 of 25% or more in a preliminary dose-response test 30 min after inhalation of 4 mg nedocromil sodium, 10 mg sodium cromoglycate, or placebo. FEV1 and SRaw were recorded at intervals for 195 min. After placebo, LASA caused a maximal decrease in FEV1 of 42 +/- 4% of baseline. After cromoglycate and nedocromil the maximal decrease in FEV1 was reduced to 20 +/- 3% and 18 +/- 4%, respectively (p < 0.01 versus placebo for both treatments), without significant differences between the two treatments. Similar results were observed with SRaw. We conclude that, at the recommended therapeutic doses, sodium cromoglycate and nedocromil sodium are equally effective in attenuating aspirin-induced bronchoconstriction and that it is unlikely that platelet activation participates in the pathogenesis of aspirin-induced asthma.
奈多罗米钠和色甘酸钠对阿司匹林诱发哮喘的保护作用从未在对照研究中进行过调查。因为有报道称，体内用奈多罗米治疗后，阿司匹林在体外诱导的血小板介导的细胞毒性活性受到抑制，而色甘酸钠则无此作用，所以我们研究了这些化合物对阿司匹林诱发的支气管收缩是否也表现出不同的保护作用。10例阿司匹林诱发哮喘患者吸入4mg奈多罗米钠、10mg色甘酸钠或安慰剂30分钟后，进行单次赖氨酸乙酰水杨酸（LASA）支气管激发试验，在初步剂量反应试验中，LASA导致FEV1下降25%或更多。每隔一段时间记录195分钟的FEV1和气道阻力（SRaw）。安慰剂后，LASA导致FEV1最大下降至基线的42±4%。色甘酸钠和奈多罗米治疗后，FEV1最大下降分别降至20±3%和18±4%（两种治疗与安慰剂相比，p<0.01），两种治疗之间无显著差异。SRaw也观察到类似结果。我们得出结论，在推荐治疗剂量下，色甘酸钠和奈多罗米钠在减轻阿司匹林诱发的支气管收缩方面同样有效，并且血小板活化不太可能参与阿司匹林诱发哮喘的发病机制。
