verlukast and Bronchial-Spasm

Mast cell histamine (HA) and cysteinyl leukotrienes (CysLT) account for most of the early phase bronchospasm in asthma. However, activation of the smooth muscle CysLT1-receptor plays a major role in asthmatic bronchospasms. CysLT-receptor antagonists or CysLT-synthesis inhibitors are efficacious in asthma but do not completely abolish asthmatic bronchospasms. A recent clinical study showed that combined antagonists loratadine (H1) and zafirlukast (CysLT1) were more effective against allergic bronchospasms than either drug alone. We examined the combined efficacy of H1- and CysLT1-receptor antagonists in allergic human bronchus. The H1- and CysLT1-receptor antagonists chlorpheniramine (CTM; 1 microM) and MK-571 (0.03 microM), were tested alone and in combination, against anti-human IgE antibody (Ab)-induced contractions of passively sensitized isolated human bronchus. Ab-induced allergic contractions were reduced 15% and 36% by CTM (1 microM) and MK-571 (0.03 microM), respectively. Combined CTM (1 microM) and MK-571 (0.03 microM) significantly inhibited the Ab response by 87%. Mechanistic investigations in isolated human bronchus and cultured human cord blood mast cells suggest that H1- and CysLT-receptor interactions likely occur at the airway smooth muscle level. CTM and MK-571 synergistically inhibited human allergic bronchospasm in the present in vitro model. The mechanism underlying this synergistic activity requires further investigation.

Topics: Adult; Bronchi; Bronchial Spasm; Cells, Cultured; Dose-Response Relationship, Drug; Drug Synergism; Female; Histamine; Histamine H1 Antagonists; Humans; Immunization, Passive; Immunoglobulin E; In Vitro Techniques; Leukotriene Antagonists; Leukotriene D4; Male; Mast Cells; Membrane Proteins; Middle Aged; Muscle Contraction; Muscle, Smooth; Propionates; Quinolines; Receptors, Leukotriene

To examine the role of leukotriene D4 (LTD4) in early and late pulmonary responses to antigen, we evaluated the effects of two LTD4, antagonists, MK-571 and FPL-57231, on the changes in pulmonary resistance (RL) in the 8-h period following antigen challenge of allergic rats. A total of 69 rats, aged 6 to 8 wk, were sensitized to subcutaneous ovalbumin (OA, 1 mg) and intraperitoneal Bordetella pertussis vaccine (6 x 10(9) bacilli). At 14 days after sensitization, rats were anesthetized with intraperitoneal urethane (1.1 g/kg) and intubated endotracheally. Aerosols of OA (5% wt/vol in saline for 5 min) were administered to 24 control rats, to 11 rats that were pretreated with aerosolized FPL-57231, and to 8 rats that were pretreated with MK-571; 6 rats also received MK-571 at 2 h after OA. A control group of 13 rats was challenged with aerosols of saline. We defined an early response (ER) as an increase in RL to at least 150% of the postsaline value occurring within 1 h after OA challenge. A late response (LR) was defined as a value of RL exceeding the mean plus 2 SD of all values of RL from 75 min to 8 h after OA challenge and lasting at least 30 min. An ER was observed in 17 of 24 control rats, in 8 of 11 FPL-57231-pretreated rats, and in 3 of 8 MK-571-pretreated rats (not significant). The magnitude and duration of the ER were significantly reduced by MK-571, whereas only the duration was affected by FPL-57231.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Allergens; Animals; Bronchial Provocation Tests; Bronchial Spasm; Bronchoalveolar Lavage Fluid; Chromones; Female; Immunization; Male; Propionates; Quinolines; Rats; Rats, Inbred BN; SRS-A; Time Factors