Effects of a beta2-agonist on airway hyperreactivity in subjects with cervical spinal cord injury.
OBJECTIVE
Aerosolized ipratropium bromide or orally administered baclofen or oxybutynin chloride (Ditropan) block methacholine-associated airway hyperreactivity in subjects with chronic cervical spinal cord injury (SCI), whereas these agents do not inhibit airway hyperreactivity associated with the inhalation of histamine. The present study was performed to determine whether pretreatment with a beta2-agonist attenuates airway hyperresponsiveness in these subjects.


METHODS
Subjects with chronic cervical SCI previously demonstrating airway hyperreactivity were challenged with methacholine (n = 9) or histamine (n = 16) alone and, on a separate day, 25 min following inhalation of nebulized metaproterenol sulfate.


RESULTS
Inhalation of the beta2-agonist was associated with an increase in provocative concentration causing a 20% decrease in FEV1 (PC20) values (geometric mean) from 1.01+/-2.76 to 20.54+/-6.24 mg/mL for methacholine and from 2.29+/-2.26 to 19.82+/-5.93 mg/mL for histamine. No correlation was found between specific PC20 values for individual subjects and percentage improvement in FEV1 (liter) following inhalation of metaproterenol sulfate and between PC20 values and baseline FEV1 percent.


CONCLUSIONS
These data, combined with findings that patients with chronic high cervical SCI experience increased breathlessness following exposure to exogenous agents, suggest that long-term prophylactic beta2-agonist therapy may reduce respiratory symptoms associated with airway hyperreactivity in these patients.
DeLuca
R V
RV
Spinal Cord Damage Research Center, Veterans Affairs Medical Center, Bronx, NY, USA.
Grimm
D R
DR
Lesser
M
M
Bauman
W A
WA
Almenoff
P L
PL
D000280:Administration, Inhalation; D000318:Adrenergic beta-Agonists / Q000008:administration & dosage / Q000627:therapeutic use*; D000328:Adult; D000368:Aged; D016535:Bronchial Hyperreactivity / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology*; D001985:Bronchial Provocation Tests; D016084:Bronchoconstriction / Q000187:drug effects; D002908:Chronic Disease; D005500:Follow-Up Studies; D005541:Forced Expiratory Volume; D006632:Histamine; D006801:Humans; D009921:Metaproterenol / Q000008:administration & dosage / Q000627:therapeutic use*; D016210:Methacholine Chloride; D008875:Middle Aged; D009330:Nebulizers and Vaporizers; D009333:Neck; D012129:Respiratory Function Tests; D013119:Spinal Cord Injuries / Q000188:drug therapy / Q000503:physiopathology*; D016896:Treatment Outcome
D000318:Adrenergic beta-Agonists; D016210:Methacholine Chloride; D009921:Metaproterenol; D006632:Histamine