Neutral Endopeptidase Activity and Airway Hyperresponsiveness to Neurokinin A in Asthmatic SubjectsIn Vivo

硫醚 神经激肽A 支气管收缩 脑啡肽酶 乙酰甲胆碱 体内 安慰剂 医学 剂量-反应关系 内分泌学 曲线下面积 药理学 内科学 哮喘 化学 P物质 神经肽 呼吸道疾病 生物 病理 生物化学 替代医学 受体 生物技术
作者
D. Cheung,Mieke Timmers,A. H. Zwinderman,Jan den Hartigh,J. H. Dijkman,Peter J. Sterk
出处
期刊:The American review of respiratory disease [American Thoracic Society]
卷期号:148 (6_pt_1): 1467-1473 被引量:78
标识
DOI:10.1164/ajrccm/148.6_pt_1.1467
摘要

In a previous study we have shown that inhibition of the endogenous neuropeptide-degrading enzyme, neutral endopeptidase (NEP), potentiates airway narrowing to neurokinin A (NKA) in normal humans in vivo. In the present study, we tested the hypothesis that hyperresponsiveness to NKA in asthma is caused by a reduction in endogenous NEP activity. To that end, we used the NEP inhibitor, thiorphan, or placebo as inhaled pretreatment to NKA challenge in eight atopic asthmatic men, who were controlled by on-demand usage of beta 2-agonists alone. The dose of thiorphan pretreatment was obtained from pilot experiments in which 0.5 ml of a 2.5-mg/ml concentration appeared to be the maximally effective nebulized dose. Dose-response curves to inhaled NKA (1 to 125 micrograms/ml, 0.5 ml/dose) were recorded on 2 randomized days 1 wk apart, in a cross-over study. To detect any effects of thiorphan on bronchoconstriction per se, we also investigated the effect of thiorphan or placebo on the dose-response curve to inhaled methacholine in a separate set of experiments. The response was measured by FEV1 and by partial expiratory flow-volume curves (V40p). The position of the dose-response curves was expressed as the concentration causing a 20% fall in FEV1 (PC20FEV1) or a 40% fall in V40p (PC40V40p). Baseline FEV1 and V40p were not affected by either pretreatment (p > 0.06). PC20FEV1 and PC40V40p to NKA were significantly lower after thiorphan pretreatment as compared with placebo (mean difference +/- SEM: 2.3 +/- 0.6 and 1.6 +/- 0.5 doubling dose, respectively; p < 0.015).(ABSTRACT TRUNCATED AT 250 WORDS)
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