Alpha 1-adrenoceptor function and autoradiographic distribution in human asthmatic lung

The pharmacologic treatment of uncomplicated arterial hypertension in patients with airway dysfunction

Because many antihypertensive drugs can affect airway function, the treatment of hypertension in patients with airway dysfunction is complex. For example, the worsening or precipitation of asthma by beta-adrenoceptor antagonists is well-recognized, but beta(1)-adrenoceptor blockers that exert mild beta(2)-agonist effects, and those that modulate the endogenous production of nitric oxide, affect airway function to a lesser extent. Therapy with selective alpha(1)-blockers is not contraindicated in cases of chronic airway obstruction. Conversely, alpha(2)-agonists must not be given to asthmatic subjects because they can adversely affect the bronchi. Calcium channel blockers do not exert severe side effects on the airways. Angiotensin-converting enzyme inhibitors may cause cough and exacerbate or even induce asthma; however, angiotensin II type I (AT(1)) antagonists do not cause cough. 5-Hydroxytryptamine modifiers such as urapidil are a treatment option for patients with chronic airway obstruction. In patients with airway dysfunction, we suggest treatment with thiazide diuretics as the initial drug choice, and calcium channel blockers if the response is poor. In the case of no response, calcium channel blockers alone must be used. However, there is no strict rule because individual patients may respond differently to individual drugs and drug combinations. Consequently, it is important to adopt a flexible approach. For patients who are unresponsive to the aforementioned drugs, AT(1) receptor antagonists, newer beta(1)-adrenoceptor-blocking agents with ancillary properties (eg, celiprolol or nebivolol), and/or vasodilators can be considered.

Pulmonary function in nonsmokers following exposure to sidestream cigarette smoke

Ten healthy male and 10 healthy female, "never-smoking" subjects (ages 21-50) participated in a 5-day environmental room study to determine if an acute exposure to a high level of fresh diluted sidestream smoke (FDSS) would alter pulmonary function. On Monday, Tuesday, Thursday and Friday, the twenty subjects sat in an environmental room for 7.33 hours and were exposed to filtered and humidified air. On Wednesday, the twenty subjects were exposed in an environmental room for 7.33 hours to an average respirable suspended particle (RSP) concentration of 179 micrograms per m3 of FDSS generated by machine smoking Kentucky 1R4F reference cigarettes. This level of FDSS is 3.3 times the 95th percentile concentration of workplace environmental tobacco smoke exposure levels previously measured in the US. FVC and FEV1 decreased approximately 1.6% (p < 0.05) in both males and females after exposure. Similarly, PEF decreased approximately 1.3% (p < 0.03) following exposure. The observed decrease in pulmonary function was consistent with a "stress" related norepinephrine-induced alteration in blood flow leading to transient bronchoconstriction. Alternatively, a cholinergic reflex due to activation of bronchopulmonary C fibers may have also played a role in the transient bronchoconstriction. These small exposure-related decrements in pulmonary function were reversible.

Age and region-dependent contraction to alpha-adrenoceptor agonists in rat and guinea-pig isolated trachea

1. The influence of age and of region on alpha-adrenoceptor-mediated contraction to (-)-adrenaline and (-)-noradrenaline was examined in rat (4-136 weeks) and guinea-pig (2-156 weeks) isolated tracheal ring preparations with particular emphasis on the early (up to 12 weeks) maturation phase. 2. In rat tracheal rings, significant regional variation was observed with respect to maximal (-)-adrenaline-induced contraction, such that the greatest activity was seen in ring preparations from the laryngeal end of the trachea. Tracheal rings from the carinal end responded very poorly or were unresponsive to (-)-adrenaline, depending on animal age. These regional differences were seen across the age range. The potencies of (-)-adrenaline and (-)-noradrenaline remained unchanged with respect to animal age, but the maximum contractile tension that developed in response to these agonists increased with increasing animal age in all regions of the trachea. 3. In guinea-pig isolated tracheal tissue, maximum contractile responses (Emax) to (-)-adrenaline and (-)-noradrenaline remained unchanged with increasing animal age. In addition, there was no evidence for a region-dependence in the responsiveness of tracheal tissue to alpha-adrenoceptor-mediated contraction in this species. 4. In both guinea-pig and rat isolated tracheal tissue, alpha-adrenoceptor-mediated contraction appeared to involve the activation of alpha1-adrenoceptors.

The role of neurotransmitters in bronchial asthma

Neural control of airway caliber is far from simple and it is likely to contribute to the airway narrowing in asthma and chronic obstructive airway disease (COAD). Complex interactions may occur between the different components of autonomic control and inflammatory mediators released from cells in the inflamed airway may profoundly alter the balance of neural control. Further elucidation of these interactions should shed light on the mechanisms of airway disease and may lead to therapeutic advances.

Adrenoceptors in airway smooth muscle

This review examines the roles and functional significance of alpha and beta-adrenoceptor subtypes in airway smooth muscle, with emphasis on human airway function and the influence of asthma. Specifically, we have examined the distribution of beta-adrenoceptors in lung and the influence of age, the epithelium, respiratory viruses and inflammation associated with asthma on airway smooth muscle beta-adrenoceptor function. Sites of action, beta 2-selectivity, efficacy and tolerance are also examined in relation to the use of beta 2-agonists in man. In addition, alpha-adrenoceptor function in airway smooth muscle has been reviewed, with some emphasis on comparing observations made in airway smooth muscle with those in animal models.

Distribution of beta 1- and beta 2-adrenoceptors in mouse trachea and lung: a quantitative autoradiographic study

1. Binding and quantitative autoradiography were used to detect [125I]-iodocyanopindolol (I-CYP) associated with beta 1- and beta 2-adrenoceptors in mouse tracheal epithelium and airway smooth muscle as well as in lung parenchymal tissue. 2. Specific I-CYP binding to slide-mounted tissue sections of both trachea and parenchyma was of high affinity (KD = 49.0 pM, n = 3, trachea; KD = 118.9 pM, n = 3, parenchyma) and saturable, involving single populations of non-interacting binding sites (Hill coefficient nH = 1.00 +/- 0.02, trachea; nH = 0.99 +/- 0.03, parenchyma). 3. Direct measurement of tissue radioactivity also showed that specific I-CYP binding was competitively inhibited in the presence of the beta-adrenoceptor antagonists (-)-propranolol (non-selective), CGP 20712A (beta 1-selective) and ICI 118,551 (beta 2-selective). Analysis of the competition binding curves for the two selective antagonists revealed mixed populations of beta 1- and beta 2-adrenoceptors in the approximate proportions 33% and 67% respectively in mouse trachea and 28% and 72% respectively in mouse lung parenchyma. 4. Densities of autoradiographic grains derived from specific I-CYP binding to alveolar wall tissue and to tracheal epithelium and airway smooth muscle were quantified by a computer-assisted image analysis system, which allowed the construction of competition binding curves in the presence of the selective beta-adrenoceptor antagonists CGP 20712A and ICI 118,551. Analysis of these data demonstrated that in alveolar wall, beta 1- and beta 2-adrenoceptors co-existed in the proportions 18% and 82%, respectively. 5. Quantitative autoradiographic analyses also showed that beta 1- and beta 2-adrenoceptors were differentially distributed in tracheal epithelium and airway smooth muscle. The beta 2-adrenoceptor subtype accounted for 71% of all beta-adrenoceptors in epithelium. Conversely, beta l-adrenoceptors which mediate relaxant responses of mouse trachea to beta,-adrenoceptor agonists (Henry & Goldie, 1990), accounted for 69% of all beta-adrenoceptors in the airway smooth muscle.