Abstract
To investigate whether endogenous transmitters play a role in different forms of bronchial asthma we determined histamine and noradrenaline plasma levels as well as airway resistance (Rt) before and after exercise and allergen challenge in children. The study demonstrates that in exercise induced asthma (EIA) broncho-constriction was paralleled by increases of noradrenaline, but not of histamine plasma levels. This increase of noradrenaline was much more pronounced than that observed in the asthmatic control group not suffering from EIA. In contrast to what has been observed in EIA, bronchoconstriction in response to allergen challenge was closely associated with increases of histamine, but not of noradrenaline plasma levels. Between histamine concentrations and severity of illness a good correlation was found (r=0.98). Tests carried out after oral administration of theophylline showed a protection against EIAand allergic induced asthma. Since theophylline in allergic asthma concomitantly reduced the increase in Rt and plasma histamine it is suggested that at least part of the beneficial effects of theophylline in allergic asthma may result from inhibition of histamine release. In those children suffering from EIA theophylline did not affect noradrenaline release. Thus, consideration must be given to effects of theophylline against EIA which are based on other mechanisms. Whether these effects are solely attributable to relaxation of bronchial smooth muscle or not remains to be clarified. In conclusion this study clearly has identified exercise and allergic induced asthma as different types of the syndrome that we call asthma. Drugs which prevent against both types may do this by different modes of action.
Published Version
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