Salbutamol-induced increased airway responsiveness to allergen and reduced protection versus methacholine: Dose response☆,☆☆,★,★★
Section snippets
Subjects
Ten atopic volunteers with stable asthma and an FEV1 ≥ 70% of that predicted were included in the study. Subjects did not take asthma medications for at least 4 weeks and had no allergen exposure or respiratory tract infection for at least 4 weeks and during the study period. All had at least one allergen to which there were both historical and skin test evidence of high degree of type I sensitivity. This study was approved by the University of Saskatchewan Advisory Committee on Ethics in Human
RESULTS
The anthropometric data, details of lung function, and allergen challenge are given in Table I. There was one protocol violation. Subject 6, with an initial screening allergen PC20 of 1:8, did not respond by more than 10% to allergen at 1:4 dilution after the first treatment. No further allergen challenges were done with this individual; however, the remainder of the study was completed and data were analyzed for FEV1, Δ FEV1, methacholine PC20, and dose shift.
The four baseline FEV1 values
DISCUSSION
The present study confirms our earlier finding of increase, almost doubling, in airway responsiveness to allergen after regular use of inhaled salbutamol for 1 week. This increase in responsiveness was significant only after use of inhaled salbutamol 800 μg per day. Although there was a slight increase (less than one quarter of a doubling concentration) after salbutamol 200 and 400 μg/day, it failed to achieve statistical significance compared with the placebo period. Seven of the 10 had not
Acknowledgements
We thank Jacquie Bramley for assistance in the preparation of the manuscript.
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From the Division of Respiratory Medicine, Department of Medicine, Royal University Hospital, Saskatoon, Saskatchewan, Canada.
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Supported by a grant from the Saskatchewan Lung Association.
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Reprint requests: Donald W. Cockcroft, MD, Division of Respiratory Medicine, Royal University Hospital, 103 Hospital Drive, Ellis Hall, 5th Floor, Saskatoon, Saskatchewan S7N 0W8 Canada.
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