BRONCHIAL RESPONSIVENESS TO INHALED LEUKOTRIENE D_4 IN BRONCHIAL ASTHMA : Part 2.Influence of Vagal Reflex on the Bronchoconstriction Caused by Inhaled Leukotriene D_4

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  • Yamai Takao
    Department of Medicine and Clinical Immunology, Dokkyo University School of Medicine
  • Yukawa Tatsuo
    Department of Medicine and Clinical Immunology, Dokkyo University School of Medicine
  • Fukuda Takeshi
    Department of Medicine and Clinical Immunology, Dokkyo University School of Medicine
  • Makino Shohei
    Department of Medicine and Clinical Immunology, Dokkyo University School of Medicine

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  • 気管支喘息における吸入ロイコトリエンD_4の気道反応性の検討 : 第2報 迷走神経反射の関与についての検討

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Abstract

In our previoue study, it was suggested that inhaled leukotriene D_4 (LTD_4), acetylcholine, and histamine caused bronchoconstriction partially through a common mechanism, scince there were good correlations between bronchial responsivensess to them in asthmatic patients. There is a possibility that the common mechanism is the irritant receptor-vagal reflex. To determine whether inhaled LTD_4 causes bronchoconstriction by means of the vagus nerve, we investigated the degree to which vagal reflex influenced to the bronchoconstriction caused by inhaled LTD_4. LTD_4 inhalation tests with a pre-test inhalation of atropine sulfate or xylocaine, were carried out on seven asthmatic subjects and bronchial responsiveness of each was compared with that of a control. Bronchial responsiveness to LTD_4 was expressed as PD_<20>-LTD_4 (provocative cumulative dose of LTD_4 causing a 20% fall in FEV_<1.0>). The baseline FEV_<1.0> was increased by atropine inhalation, but decreased by xylocaine inhalation in all of the asthmatic subjects, and these changes were statistically significant (p<0.01). The geometric mean ± SD of PD_<20>-LTD_4 increased from 2.77 ± 0.56 to 3.13 ± 0.37 after atropine inhalation, and the difference was statistically significant (p<0.01). After xylocaine inhalation, the geometric mean ± SD of PD_<20>-LTD_4 increased from 2.79 ± 0.48 to 3.09 ± 0.54 against the decrease of baseline FEV_<1.0>, and this difference was significant (p<0.05). These results suggest that inhaled LTD_4 causes bronchoconstriction partially through the irritant receptor-vagal reflex.

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