Plasma elevations of histamine and a prostaglandin metabolite in acute asthma.
Recent studies of laboratory-provoked asthma have suggested that asthma is an inflammatory disease of lower airways. The purpose of this study was to measure the systemic elaboration of 2 bronchoconstrictive inflammatory mediators during naturally acquired acute asthma utilizing a prospective, serial-sampling protocol. Plasma levels of 13,14-dihydro-15-keto-PGF2 alpha and histamine were measured by radioimmunoassay and radioenzymatic assay, respectively, in 23 children with acute asthma. Mean PG metabolite and histamine values (pg/ml) before (167 +/- 72, 1,029 +/- 378) and 10 to 90 min after (377 +/- 145, 1,000 +/- 489) initial therapy were significantly higher than those of the same children after resolution of asthma (2.9 +/- 0.2, 260 +/- 42) and those of normal children (4.3 +/- 0.9, 240 +/- 14). Peak PG metabolite levels were significantly higher in children who presented with PEFR values (% predicted) less than 40% (1,234 +/- 432) compared with those who presented with greater than 40% (404 +/- 296), and in children with post-therapy improvement in PEFR of less than 20% (1,281 +/- 470) compared with those with greater than 20% (365 +/- 226). Histamine levels were significantly higher in children with post-therapy improvement in PEFR of less than 20% (2,560 +/- 1,600) compared with those with greater than 20% (475 +/- 100), and in hospitalized (3,915 +/- 1,910) compared with nonhospitalized (408 +/- 130) children. Significant differences were not observed on the basis of corticosteroid dependence, allergic disposition, or type of initial therapy. These data suggest a role for histamine and PGF2 alpha in the pathogenesis of airway inflammation in acute asthma.
Skoner
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Division of Allergy/Immunology, Children's Hospital of Pittsburgh, Pennsylvania 15213.
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D000208:Acute Disease; D000293:Adolescent; D001249:Asthma / Q000097:blood* / Q000188:drug therapy / Q000503:physiopathology; D002648:Child; D002675:Child, Preschool; D015237:Dinoprost / Q000031:analogs & derivatives* / Q000097:blood; D006632:Histamine / Q000097:blood*; D006760:Hospitalization; D006801:Humans; D010366:Peak Expiratory Flow Rate; D011446:Prospective Studies
C008228:15-keto-13,14-dihydroprostaglandin F2alpha; D006632:Histamine; D015237:Dinoprost