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Mechanisms of bronchial hyperreactivity in cystic fibrosis
Author(s) -
Van Asperen Peter P.,
Manglick Patricia,
Allen Hugh
Publication year - 1988
Publication title -
pediatric pulmonology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.866
H-Index - 106
eISSN - 1099-0496
pISSN - 8755-6863
DOI - 10.1002/ppul.1950050304
Subject(s) - ipratropium bromide , fenoterol , medicine , bronchoconstriction , histamine , bronchodilator , ipratropium , asthma , anesthesia , bronchospasm , gastroenterology
We studied 14 patients with cystic fibrosis (CF) who had evidence of bronchial hyperreactivity on a standardized histamine challenge. Patients had a histamine challenge on the first day. Then they were pretreated with either 0.25 mg ipratropium bromide or 0.5 mg fenoterol hydrobromide on 2 separate days, and the histamine challenge was repeated. Baseline forced expiratory volume in 1 sec was similar on the 3 days; however, there was a small but significant (P<0.05) improvement after fenoterol. Mean PC 20 on the control day was 1.50 mg/ml, which increased significantly after pretreatment with ipratropium (2.88 mg/ml, P<0.01) and fenoterol (3.64 mg/ml, P<0.005), indicating protection against histamine‐induced bronchial hyperreactivity. The six CF patients with “coexistent asthma,” as defined by recurrent episodes of wheezing responsive clinically to bronchodilator therapy, had no significant protection from ipratropium, whereas the eight “nonasthmatic” CF patients were protected by both ipratropium and fenoterol. We postulate that at least two mechanisms contribute to histamine‐induced bronchial hyperreactivity in patients with CF, one related to vagally mediated reflex bronchoconstriction and another that acts independently of this mechanism.