Increased bronchial reactivity and potentiated skin responses in hypertensive subjects suffering from coughs during ACE-inhibitor therapy.
The aim of this study was to investigate whether ACE-inhibitors could influence bronchial reactivity and interfere with inflammatory skin responses. Ten hypertensive subjects, who had reacted with coughs during ACE-inhibitor therapy, were treated in a double-blind crossover fashion for two weeks with enalapril and with placebo. Enalapril reduced the PC20 value for histamine and augmented the dermal response. Circulating eosinophilic leukocyte level in venous blood dropped markedly after the histamine bronchoprovocation performed during enalapril treatment. Plasma substance P was reduced after histamine provocation performed during placebo treatment, whereas this reduction was abolished by enalapril. In this study, we have demonstrated ACE-inhibitor-induction of moderately increased bronchial reactivity in subjects with suspected ACE-inhibitor-elicited coughs. It is suggested that coughing during ACE-inhibitor therapy is due to an increased inflammatory state in the airways.
Lindgren
B R
BR
Department of Pharmaoclogy, Linköping University Hospital, Sweden.
Rosenqvist
U
U
Ekström
T
T
Grönneberg
R
R
Karlberg
B E
BE
Andersson
R G
RG
D000368:Aged; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000009:adverse effects*; D001980:Bronchi / Q000187:drug effects; D001985:Bronchial Provocation Tests; D003371:Cough / Q000139:chemically induced* / Q000503:physiopathology; D004311:Double-Blind Method; D003875:Drug Eruptions / Q000209:etiology* / Q000503:physiopathology; D004656:Enalapril / Q000009:adverse effects; D004804:Eosinophils / Q000276:immunology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D007271:Injections, Intradermal; D008297:Male; D008875:Middle Aged; D011897:Random Allocation; D012083:Renin / Q000097:blood
D000806:Angiotensin-Converting Enzyme Inhibitors; D004656:Enalapril; D012083:Renin