Chest
Volume 93, Issue 2, February 1988, Pages 280-284
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Clinical Investigations
Influence of Infused Adenosine on Bronchial Tone and Bronchial Reactivity in Asthma

https://doi.org/10.1378/chest.93.2.280Get rights and content

Adenosine has been found to contract human bronchial smooth muscle in vitro and to induce bronchoconstriction in asthmatic patients when administered by inhalation. The aim of the present study was to investigate if elevation of circulating levels of adenosine influence bronchial tone or bronchial reactivity. Seven patients with bronchial asthma in whom bronchial hyperreactivity had been confirmed in a pretrial bronchial histamine challenge (PC20 FEV1, 0.064 to 2.45 mg/ml) received intravenous infusions of adenosine in increasing doses (10, 30 and 50 μg/kg/min, 6 min on each dose step) or placebo (saline solution) on two different days in a randomized, single-blind manner. Heart rate, blood pressure and lung function (lung volumes, flow-volume loops and airway conductance) wre measured on each dose step. Infusion rate was held constant (at 50 μg/kg/min) throughout the trial and a bronchial methacholine challenge was performed during the infusion of adenosine or placebo. Infusions of adenosine and placebo did not influence heart rate, blood pressure or bronchial tone on either day and bronchial reactivity was similar on both days. We conclude that bronchial tone and bronchial reactivity in asthmatic patients are not increased by intravenously administered adenosine at a dose level which, in other studies, has been shown to induce regional effects in the systemic arterial circulation.

Section snippets

Patients

Seven nonsmoking subjects (three women) with a mean age of 35 ± 5 years (range 21 to 56 years), who had bronchial asthma according to the definition of the American Thoracic Society,15 participated in the study. Four had a verified allergy, and all patients had verified bronchial hyperreactivity confirmed by a pretrial bronchial histamine provocation test (PC20 FEV1, ie, the concentration of histamine that yields a reduction in FEV1 by 20 percent of the basal value, was 0.93 ±0.30 mg/ml, range

RESULTS

All patients were in a stable phase without any symptom of asthma at the time of the trial, and basal PEF (ie, the lowest basal pre-challenge value for the two days) was 77 ± 5 percent (range 66 to 98 percent) of predicted value.16 There was no significant intraindividual difference in basal lung function when the two trial days were compared. Basal PEF and Sgaw are shown in Table 1. The intraindividual difference in PEF was 4.1 ± 1.1 percent; in Sgaw, 26.3 ± 8.5 percent between the two days.

DISCUSSION

All patients were free from asthmatic symptoms at the time of the trial with PEF>66 percent of predicted value. There was no difference in lung function between the days, which makes the two days comparable.

In previous studies, inhaled adenosine (but not guanosine) in high concentrations has been found to be a bronchoconstrictor in asthmatic patients, but not in healthy subjects.7 In vitro, in guinea pig tracheal preparations, adenosine increased basal smooth muscle tension in a dose-dependent

ACKNOWLEDGMENTS

The authors thank Assistant Professor Sture Bevegård for access to laboratory facilities and Caroline Angleryd, Berith Nilsson and Helene Johansson for expert technical assistance. Supported by grants from the Swedish National Association against Heart and Chest Diseases, the Swedish Medical Research Council (7485) and the Tore Wiberg Foundation.

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    Manuscript received February 16; revision accepted June 1.

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