In vivo effect of albuterol on methacholine-contracted bronchi in conjunction with salmeterol and formoterol☆,☆☆,★
Section snippets
Subjects
Sixteen subjects (13 women and 3 men; mean [±SD] age, 39 [13] years) with mild-to-moderate asthma, all taking inhaled corticosteroids with a median dose of 450 μg/day (Table I), were recruited to take part in a randomized, double-blind, cross-over study.All patients were reactive to methacholine with PD20 values of less than 500 μg and exhibited at least a 2 doubling-dose improvement in PD20 at 20 minutes after inhalation of 400 μg of albuterol at initial screening (Table I). All had stable
Prechallenge spirometry
FEV1 was significantly (P < .05) higher 12 hours after the inhalation of formoterol or salmeterol as compared with placebo, apart from one salmeterol treatment in which the numerical trend did not achieve statistical significance before inhalation of albuterol (Fig 2).
DISCUSSION
Our results have demonstrated that prior treatment with a single dose of salmeterol and formoterol antagonized the protective effect of albuterol against methacholine-induced bronchoconstriction. This was evident by the greater degree of improvement in PD20 between low- and high-dose albuterol alone when given on a background of placebo compared with responses on a background of formoterol or salmeterol. Furthermore, the response to high-dose albuterol in conjunction with formoterol and
Acknowledgements
We thank Dr Ian Hall (University Hospital, Nottingham, UK) for performing the genotype analysis.
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Supported by a University of Dundee research grant.
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Reprint requests: Brian Lipworth, MD, Professor of Allergy and Respiratory Medicine, Ninewells Hospital and Medical School, University of Dundee, Dundee, DD1 9SY, Scotland, UK.
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0091-6749/99 $8.00+0 1/1/97163