The amplifier role of platelet activating factor (PAF), other chemical mediators and antigen in the induction of airway hyperreactivity to cold

Exercise- and cold-induced asthma

Exercise- and cold-induced asthma are commonly recognized respiratory disorders. The asthmatic response includes several factors contributing to airway narrowing, and thus increased airway resistance. These include airway smooth muscle contraction, mucus accumulation, and bronchial vascular congestion as well as epithelial damage and vascular leakage. The etiology for these disorders is nonantigenic. The primary stimulus is probably a combination of airway cooling and drying (leading to hypertonicity of airway lining fluid). Symptoms generally do not occur during the stimulus period (e.g., exercise) itself. This protection may in part be due to increased catecholamine levels during exercise. The early phase response, which occurs 5 to 15 min poststimulus, may be mediated through a combination of (a) direct influences, (b) vagal reflexes triggered by airway sensory receptors, or (c) responses to mediator release. Spontaneous recovery occurs within 30 min to 2 hrs. There is usually a refractory period of about 1 to 2 hrs during which responses to further stimuli are attenuated. This may be due to depletion of histamine and other mediators. As well, prostaglandin release (mediated via LTD4 which is released during exercise) inhibits further airway narrowing. A late phase response has been reported 4 to 10 hrs poststimulus in some patients. These reactions are accompanied by a second release of histamine and other mediators that cause inflammatory responses and epithelial damage. However, the exercise dependence of this response is debated.

Antagonism of platelet-activating factor in isolated rat colon: possible mechanism

The contractions of three different regions of rat colon in response to platelet-activating factor (PAF) were compared. The ascending colon was found to be the most responsive. The slow contraction of the ascending colon induced by PAF was dependent on external Ca2+. CV-3988, a structural analog of PAF, slowly induced irreversible inhibition of PAF-induced contraction, whereas FR-900452, which is structurally unrelated to PAF, caused rapid reversible inhibition of PAF-induced contraction. No inhibitory effects of CV-3988 were observed when the strip was washed with Tyrode's solution containing 1% bovine serum albumin (BSA). The results suggest that PAF and CV-3988 penetrate slowly into the outer half of the lipid bilayer of plasma membranes of cells in isolated rat colon, and then rapidly diffuse laterally to associate firmly with specific binding sites.

Body temperature modulates the effect of platelet-activating factor (PAF) on airways responsiveness in the rabbit

Platelet-activating factor (PAF) is a potent mediator known to cause bronchoconstriction and increase airways responsiveness. In vitro studies have shown that the effects of PAF on cell function can be very temperature-dependent. The aim of the current study was to investigate the effect of elevated body temperature on numbers of circulating cells and pulmonary function in anesthetized rabbits in response to PAF. PAF was given intravenously, at a dose of 1.2 micrograms/kg hour, whereas the control experiments were performed after the animals received a saline infusion. Alteration of airways function was assessed by measuring specific pulmonary conductance (SGL) and dose-response relationships to inhaled histamine, where airways responsiveness was expressed as the effective concentration causing 50% of maximal change in specific airways conductance (EC50SGL). The rabbits were studied at two body temperatures: a normal temperature (rectal temperature of 39.8 C), and a higher temperature (rectal temperature 41.2 degrees C). Changes in circulating inflammatory cells, plasma corticosterone concentrations and in hematocrit were also monitored, to examine some potential mechanisms which might explain why body temperature altered airways responsiveness. At the normal body temperature infusion of PAF caused a significant increase in airways responsiveness (p less than 0.025), while at the high body temperature, there was a significant decrease in responsiveness (p less than 0.025). However, at both body temperatures, a profound but similar thrombocytopenia and neutropenia was observed. While plasma corticosterone levels and hematocrit showed increases coincident with the infusion of PAF, this response was unchanged by altering body temperature. We conclude that increased body temperature reduces the effect of PAF on airways responsiveness apparently through a mechanism independent of PAF effects on hemoconcentration, plasma corticosterone or circulating inflammatory cells.

Induction of non-specific airway hyperreactivity by potassium channel blockade in rat isolated trachea

1. The exposure of rat isolated tracheal segment to the K(+)-channel inhibitor tetraethylammonium (TEA, 10 mM) for a period of 10-15 min generally produced little or no contractile response. 2. Cooling (10 C) provocation alone usually produced small (10 +/- 3% acetylcholine maximum) contractile responses. 3. In the presence of TEA (10 mM, 10-15 min exposure), rat trachea exhibited airway hyperreactivity to acetylcholine, 5-hydroxytryptamine (5-HT) and cooling. It also increased the peak tension induced by 5-HT. 4. TEA-induced airway hyperreactivity to cooling was significantly inhibited in Ca2(+)-free Krebs solution suggesting an important role for extracellular Ca2+ influx. 5. We conclude that the blockade of potassium channels with TEA induces non-specific airway hyperreactivity to cooling, 5-HT and acetylcholine in rat isolated tracheal segments.

Effects of a PAF-antagonist (BN 52063) on bronchoconstriction and platelet activation during exercise induced asthma

1. The effects of a specific PAF acether antagonist (BN 52063) on the response to isocapnic hyperventilation with dry cold air (ISH study) and exercise (EIA study) were assessed in a single dose and short term treatment study in 10 patients with exercise induced asthma. 2. ISH challenge was performed twice within 1 h after administration of either placebo, 240 mg BN 52063 p.o. or inhalation of 2.4 mg BN 52063. Hyperventilation increased Raw from 0.30 +/- 0.02 to 0.89 kPa s l-1 (P less than 0.001) after the first challenge and from 0.28 +/- 0.04 to 0.84 +/- 0.06 kPa s l-1 (P less than 0.001) after the second challenge. Oral pretreatment with BN 52063 did not result in a reduction of bronchoconstriction during both challenges. A significant increase of Raw was noted immediately after inhalation of BN 52063. An inhibition of PAF induced platelet aggregation (by a factor of 2) occurred after oral administration of BN 52063 after both ISH challenges (P less than 0.05). No significant inhibition of PAF induced platelet aggregation was seen after inhalation of BN 52063. At concentrations up to 30 microM in vitro, BN 52063 inhibited PAF induced platelet aggregation in a dose dependent manner. The IC50 of BN 52063 against the aggregating effect of 1 microM PAF was 7.0 +/- 2.1 microM. 3. In the EIA study the patients were challenged on the third day of treatment with either placebo or 240 mg BN 52063 p.o. or 5 mg BN 52063 by inhalation. Peak expiratory flow rates (PEFR) fell by 155 +/- 37 1 min-1 after exercise.(ABSTRACT TRUNCATED AT 250 WORDS)

Effects of a novel PAF antagonist, E6123, on passive anaphylaxis

E6123 inhibited antigen-induced bronchoconstriction, the development of bronchial hyperreactivity and eosinophil infiltration in the airway in passively sensitized guinea pigs and protected mice from anaphylactic death. The inhibitory effects of E6123 on anaphylactic response were very potent compared with those of WEB 2347 and Y-24180.

Phospholipase A2 induced airway hyperreactivity to cooling and acetylcholine in rat trachea: pharmacological modulation

1. Rat isolated tracheal smooth muscle preparations respond to phospholipase A2 (PLA2) and phospholipase C (PLC) with contractile responses of highly variable magnitudes. Rat tracheae exposed to PLA2 or PLC for a period of 10-30 min, exhibit airway hyperreactivity (AH) to cooling (10 degrees C), i.e., respond with strong contractile responses. Phospholipase D neither contracted rat tracheae nor induced AH to cooling. 2. PLA2-induced AH to cooling was dependent on the presence of extracellular Ca2+ in the physiological solution. 3. Verapamil, azelastine, diltiazem and TMB-8 (each 10 microM) significantly attenuated PLA2-induced AH. This effect was not shared by nifedipine (10 microM). 4. Bepridil (10 microM), a Ca2+ and calmodulin antagonist, also significantly attenuated AH induced by PLA2. 5. Indomethacin (a cyclo-oxygenase inhibitor), AA-861 (a selective 5-lipoxygenase inhibitor), FPL 55712 (a leukotriene receptor antagonist), methysergide (a 5-hydroxytryptamine D-receptor antagonist) and pyrilamine (a histamine H1-receptor antagonist) exerted little or no effect on PLA2-induced AH to cooling. 6. Atropine significantly attenuated PLA2-induced AH suggesting the participation of acetylcholine. 7. Nordihydroguaiaretic acid (an antioxidant; 5-lipoxygenase inhibitor) and BW 755C (an antioxidant; a dual inhibitor of cyclo-oxygenase and 5-lipoxygenase) significantly attenuated PLA2-induced AH to cooling. 8. In conclusion, these data show that PLA2 (an enzyme involved in the synthesis of Paf-acether, prostaglandins, thromboxanes, leukotrienes, diacylglycerol, superoxide free radicals and lipid peroxides, etc.) induces AH to cooling and acetylcholine in rat trachea. The induction of AH to cooling is dependent on the presence of extracellular Ca2+ and is significantly attenuated by verapamil, diltiazem, bepridil, atropine and azelastine (an antiallergic/antiasthmatic drug).

Lipoxygenase metabolites mediate increased airways responsiveness to histamine after acute platelet activating factor exposure in the guinea-pig

Platelet activating factor (Paf, 0.02 micrograms/kg, i.v. bolus) caused an acute increase in airways responsiveness to histamine in anaesthetized guinea-pigs prepared for recording airways resistance (RL) and dynamic compliance (Cdyn). Aspirin pretreatment (10 mg/kg, i.v.) attenuated the return of airways responsiveness to prechallenge levels. Pretreatment with the combined cyclooxygenase/lipoxygenase inhibitors BW 755C (20 mg/kg, i.v.) and ETYA (20 mg/kg, i.v.), or with the putative cysteinyl-containing leukotriene antagonist FPL 55712 (0.25 mg/kg/min, i.v.), or a Paf antagonist SRI 63441 (2.5 mg/kg, i.v.), prevented Paf-induced increased airways responsiveness. Inhibitors of leukotriene synthesis, BW 755C and ETYA, or action, FPL 55712, had variable effects on Paf-induced bronchoconstriction. These data suggest that lipoxygenase metabolites, possibly leukotrienes, may mediate an acute increase in airways responsiveness to histamine after Paf exposure.

Allergic responses and subsequent development of airway hyperreactivity to cold provocation in the rat trachea: pharmacological modulation

An in vitro model of airway hyperreactivity to cold provocation was developed. Cold provocation (10 degrees C) alone was not sufficient to cause contraction of rat isolated tracheal smooth muscle preparations. However, following recovery from antigen-induced responses in sensitized rat tracheal segments, cold provocation resulted in marked contractile responses. L-652,731 (a Paf-acether antagonist) and atropine significantly attenuated antigen-induced responses and subsequent development of airway hyperreactivity to cold provocation. Indomethacin augmented allergic responses and subsequent development of airway hyperreactivity to cold challenge. Nordihydroguaiaretic acid, FPL 55712 and theophylline did not exert any effect. The data obtained in this study showed that (i) Paf-acether and acetylcholine may play an important role in the mediation of allergic responses and subsequent development of airway hyperreactivity to cold provocation; (ii) the significant attenuation of antigen-induced airway hyperreactivity to cold provocation by Ca2+ channel blockers (nifedipine, bepridil and TMB-8) suggests an increase in Ca2+ influx/permeability following antigen challenge which appears to be responsible for the development of airway hyperreactivity to cold provocation; and (iii) 5-HT, prostaglandins or thromboxanes and leukotrienes play little or no role in the mediation of allergic responses and subsequent development of airway hyperreactivity to cold exposure in rat trachea.

The obligatory role of calcium in the development of antigen-induced airway hyperreactivity to cold provocation in the rat isolated trachea

The effect of antigen challenge on cold provocation (30-10 degrees C) in isolated tracheal segments from control (normal) and ovalbumin-sensitized rats was studied. Sensitization alone or acute cold provocation (10 degrees C) alone was not sufficient to cause contraction of tracheal smooth muscle preparation. Following recovery from antigen-induced responses (Schultz-Dale phenomenon) in sensitized rat segments, cold provocation induced strong contractile responses. Both the antigen-induced contractions and the subsequent development of airway hyperreactivity to cold were dependent on extracellular Ca2+ and inhibited by verapamil. The data in this study indicate that extracellular Ca2+ plays an obligatory role in the mediation of antigen-induced contractile responses as well as the subsequent development of hyperreactivity to cold provocation in rat tracheal smooth muscle.

Inhibition of leukotriene (SRS-A)-mediated acute lung anaphylaxis by azelastine in guinea pigs

Azelastine hydrochloride, chemically known as 1(2H)-phthalazinone, 4-[(4-chlorophenyl)methyl]-2-(hexahydro-1-methyl-1H-azepine-4-yl)-, monohydrochloride, is a novel, orally effective, long-acting, antiallergic/antiasthmatic agent. The ability of azelastine and selected antiallergic drugs to inhibit SRS-A (leukotriene)-mediated acute lung anaphylaxis in guinea pigs (Konzett-Rossler method) was investigated. Azelastine and ketotifen were administered p.o. 2 and 24 h before antigen challenge; disodium cromoglycate (DSCG) was administered i.v. immediately before antigen challenge. The oral dose of azelastine required to inhibit leukotriene-mediated allergic bronchospasm by 50% (ID50: mg/kg) was 0.063 at 2 h and 0.120 at 24 h. Ketotifen at a dose of 0.05 to 10 mg/kg at 2 and 24 h, p.o., as well as DSCG at a dosage of 0.3 to 10 mg/kg at 0 min, i.v., produced weak, inconsistent and nondose-related antianaphylactic effects. Azelastine is an orally effective and long-acting inhibitor of in vivo synthesis and/or release of leukotrienes.