Beta 2-adrenoceptor stimulation inhibits ganglionic transmission in ferret trachea

The Use of Antiallergic and Antiasthmatic Drugs in Viral Infections of the Upper Respiratory Tract

Despite their frequency, upper respiratory tract infections (URTIs) constitute an area with few, if any, effective treatment remedies. Asthma and airway allergies share similar pathogenetic mechanisms to URTIs and it is not surprising, therefore, that agents used to treat allergic disorders have also been studied in URTIs. Their possible effects, limitations and hypothetical modes of action in URTIs are reviewed. In controlled clinical trials of satisfactory scientific standard, symptom reductions in both experimental rhinovirus infections and natural colds have occurred with topical anticholinergics, oral antihistamines and topical chromones. Future treatment alternatives for URTIs may include the intranasal anticholinergic ipratropium bromide, new nonsedating antihistamines and sodium cromoglycate (cromolyn sodium). The latter has a record of safety and an absence of adverse effects that would make it an attractive alternative for this common but not particularly serious condition in otherwise healthy individuals.

NANC neural control of airway smooth muscle tone

1. This review addresses the functional role of the nonadrenergic, noncholinergic (NANC) neural response in the control of airway smooth muscle tone. 2. Functional data from guinea pig airways in vitro indicate that the level of basal smooth muscle tone determines the direction and magnitude of the NANC neural response such that it can stabilise tone. 3. The NANC stabilising effect on tone is adjustable through variation in impulse frequency and the NANC stabilising effect is also powerful; it can abolish near-maximum differences in tone. 4. Cholinergic activation increases the level towards which the NANC responses tend to adjust tone. 5. Adrenergic activation reduces the level towards which the NANC responses tend to adjust tone via beta-adrenoceptors. 6. NANC neural activation, with or without simultaneous adrenergic or cholinergic activation, can stabilise tone at low, intermediate or high levels with a high degree of accuracy. 7. Evidence from other investigators on effects of putative NANC neurotransmitters supports the idea of functional interactions within the NANC system in the airways. 8. It remains to be confirmed whether or not NANC responses play a stabilising role in the control of airway smooth muscle tone in vivo and in higher mammals.

Beta-adrenoceptors on smooth muscle, nerves and inflammatory cells

Although the bronchodilator action of beta 2-adrenoceptor agonists in asthma is largely due to relaxation of airway smooth muscle, these agents have other effects which may contribute to their anti-asthma action. Human airway smooth muscle contains only beta 2-receptors which, when stimulated, stimulate a rise in intracellular cAMP and activation of PKA (protein kinase A), which in turn phosphorylates several cellular proteins, resulting in relaxation. However, beta-agonists also influence membrane K+ channels and induce smooth muscle relaxation without a rise in cAMP, and this mechanism appears to be the major feature of bronchodilatation in asthma. There is also evidence that beta-agonists may modulate neurotransmission in airways via prejunctional receptors on airway nerves, both sensory and motor. Blockade of prejunctional beta 2-receptors in asthma patients may lead to marked rise in acetylcholine release, with severe bronchoconstriction. Although beta-agonists have little or no effect on the chronic inflammatory response which underlies chronic airway hyper-responsiveness, they do inhibit the release of histamine from mast cells in vitro. The presence of beta-receptors has also been detected not only on mast cells but also on eosinophils, macrophages, lymphocytes and neutrophils, but beta-agonists have little or no inhibitory action on the activities of all these cells due to rapid tachyphylaxis.