Low-dose salbutamol suppresses airway responsiveness to histamine but not methacholine in subjects with asthma

Abstract

Background: Airway hyperresponsiveness is a cardinal feature of asthma. Although the modulation of cholinergic neuroeffector transmission may play a role in airway responsiveness, in vivo evidence remains scarce. It is well known that histamine causes bronchoconstriction partly via vagal reflex, whereas methacholine does not. To investigate the significance of modulating neuroeffector transmission, we compared the effect of low-dose salbutamol-a β2-adrenoceptor agonist-on airway responsiveness to histamine with that to methacholine.

Methods: We enrolled 12 subjects with stable asthma. After screening confirmed that inhalation of low-dose salbutamol (1μg) did not change their basic pulmonary function, subjects underwent measurement of airway responsiveness to inhaled histamine and methacholine with or without pretreatment with low-dose salbutamol, in a randomized, crossover fashion. Airway responsiveness was measured by an astograph by which respiratory conductance (Grs) was assessed by the forced oscillation method during continuous inhalation of histamine or methacholine in stepwise incremental concentrations. Airway responsiveness was calculated as the cumulative dose of bronchoconstrictors that induced a decrease of 35% in Grs.

Results: Inhalation of 1μg of salbutamol significantly attenuated airway responsiveness to histamine but not methacholine. This selective attenuation was observed irrespective of disease severity or phenotype, namely atopy or non-atopy.

Conclusion: Low-dose salbutamol suppresses airway responsiveness to histamine but not methacholine in subjects with asthma. The present study may provide a novel insight into the bronchoprotective mechanism of β2-adorenoceptor agonist in clinical settings.

Keywords: ACh; Airway responsiveness; EFS; GSEM; Grs; LABA; MCh; Neuroeffector transmission; PD(35)-Grs; PGE(2); RAST; Rrs; SABA; Salbutamol; Vagal reflex; acetylcholine; electrical field stimulation; geometric standard errors of means; long-acting β(2)-adrenoceptor agonist; methacholine; prostaglandin E(2); radioallergosorbent test; respiratory conductance; respiratory resistance; short-acting β(2)-adrenoceptor agonist; the cumulative dose of bronchoconstrictor that induced a decrease of 35% in Grs.