Reduced protection against exercise induced bronchoconstriction after chronic dosing with salmeterol

Ramage, L.; Lipworth, Brian J.; Ingram, Charles G.; Cree, I A; Dhillon, D P

doi:10.1016/0954-6111(94)90042-6

Cited by 247 publications

(98 citation statements)

References 19 publications

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“…Recent studies have shown that 2-4 weeks regular treatment with 50 µg twice daily reduced the protective effect of the drug against EIA [33] and cold air challenge [34]. The design of the present study excluded the possibility of this phenomenon, in fact no patient had used salmeterol regularly.…”

Section: Discussionmentioning

confidence: 76%

Salmeterol in exercise-induced bronchoconstriction in asthmatic children: comparison of two doses

Benedictis¹,

Tuteri²,

Pazzelli³

et al. 1996

Eur Respir J

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S Sa al lm me et te er ro ol l i in n e ex xe er rc ci is se e--i in nd du uc ce ed d b br ro on nc ch ho oc co on ns st tr ri ic ct ti io on n i in n a as st th hm ma at ti ic c c ch hi il ld dr re en n: : c co om mp pa ar ri is so on n o of f t tw wo o d do os se es s Twelve children (aged 7-14 yrs) with asthma were studied in a double-blind, cross-over, placebo-controlled design. On three separate days, exercise tests were performed 1 h and 12 h after administration of the drug. Pulmonary function measurements were performed before drug inhalation, before every exercise test and 1, 5, 10, 15 and 30 min after the end of exercise. The response was expressed as maximal decrease in forced expiratory volume in one second (FEV1).Both doses of salmeterol provided significant bronchodilation for up to 12 h, with no difference between them. Maximal exercise-induced decrease in FEV1 (% fall) 1 h after pretreatment was (mean±SD) 35±16, 10±10 and 4±3% for placebo, 25 and 50 µg salmeterol, respectively. At 12 h after pretreatment these values were 31±14, 19±12 and 15±13%, respectively. Individual protection against exercise-induced bronchoconstriction at 1 and 12 h did not vary between the dosages (p<0.05), even though the protection obtained by 25 µg at 12 h was no longer significant versus placebo.We conclude that 25 µg of inhaled salmeterol provides equally effective long-lasting bronchodilation and acute protection against exercise-induced bronchoconstriction as 50 µg, and may be a suitable dose for most asthmatic children.

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Section: Discussionmentioning

confidence: 76%

Salmeterol in exercise-induced bronchoconstriction in asthmatic children: comparison of two doses

Benedictis¹,

Tuteri²,

Pazzelli³

et al. 1996

Eur Respir J

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“…As inhaled long-acting β 2 agonists rapidly loose their protective effect on exercise-provoked asthma when used on a regular basis (62)(63)(64), their use may not be advocated in subjects who exercise regularly in cold weather. For those subjects, leukotriene receptor antagonists may be more suitable since they are as effective as long-acting β 2 agonists in this setting (49,65) and do not loose their protective effect when used on a regular basis (63)(64)(65).…”

Section: Cold Air-provoked Short-term Responsesmentioning

confidence: 99%

Cold air-provoked respiratory symptoms: the mechanisms and management

Koskela

2007

International Journal of Circumpolar Health

188

137

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Objectives. To describe the mechanisms and management of cold air-provoked respiratory symptoms. Study design. A literature review. Methods. The review includes human epidemiological studies, human and animal experimental studies, as well as human studies about management of the cold air-provoked respiratory symptoms. Results. Cold air is unlikely to be a causal factor initiating respiratory diseases but a symptom trigger. In the present review, the airway responses beyond these symptoms were divided into three types. The short-term responses are those that develop within minutes in response to sudden cooling of the airways. Subjects with asthma or rhinitis are especially prone to these responses. The long-term responses are those that develop in response to repeated and longstanding cooling and drying of the airways, usually in endurance athletes. Finally, there are the physiological, reflex-mediated lower-airway responses to cooling of the skin or upper airways. Conclusions. The mechanisms beyond cold air-provoked respiratory symptoms vary considerably and mainly depend on the individual's susceptibility and the ventilation level during the cold exposure. An understanding of these mechanisms is essential for successful management of the symptoms. (Int J Circumpolar Health 2007; 66(2) [91][92][93][94][95][96][97][98][99][100]

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“…However, prolonged use of salbutamol or terbutaline reduces the protection afforded against bronchoconstriction induced by methacholine [21][22][23], exercise [24] or antigen challenge [21,23] and has been shown to increase the magnitude of the late asthmatic response induced by allergen [25]. Similarly, regular treatment with salmeterol also leads to a loss in protection against bronchospasm induced by methacholine [26,27] and exercise [28]. Furthermore, β 2 -adrenoceptor agonists have been demonstrated to steepen the dose-response curve to methacholine [15,16].…”

Section: Discussionmentioning

confidence: 99%

Effect of chronic theophylline treatment on the methacholine dose-response curve in allergic asthmatic subjects

Page

Cotter²,

Kilfeather³

et al. 1998

Eur Respir J

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Theophylline is a bronchodilator and immunomodulator drug which has recently been demonstrated to attenuate the recruitment and activation of inflammatory cells into lungs of asthmatics. This study investigated the effect of chronic treatment with theophylline for its ability to alter airway responsiveness, as indicated by changes in airway sensitivity and reactivity to inhaled methacholine. The subjects studied were mild asthmatics who relied on beta-agonist medication only and who were randomized into two groups, one receiving theophylline (median dose 250 mg twice daily; range 250-375 mg twice daily) and the other placebo. A number of parameters was measured before and after treatment, including baseline forced expiratory volume in one second (FEV1), the provocative concentration of methacholine causing a 20% fall in FEV1 (PC20; sensitivity), dose-response slope (reactivity) and percentage eosinophils, eosinophil cationic protein and T-cell markers in peripheral blood (by flow cytometry). After 2 months of treatment with theophylline there was a significant lowering of airway reactivity (slope) to methacholine and improvement in methacholine sensitivity (PC20). However, such changes were not associated with any significant change in the number or activation status of eosinophils and lymphocytes in peripheral blood. In conclusion, chronic treatment with theophylline reduces the reactivity of the airways to methacholine, which might be beneficial in the treatment of persistent asthma. The cellular mechanisms of this improvement remain to be clarified.

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Reduced protection against exercise induced bronchoconstriction after chronic dosing with salmeterol

Cited by 247 publications

References 19 publications

Salmeterol in exercise-induced bronchoconstriction in asthmatic children: comparison of two doses

Salmeterol in exercise-induced bronchoconstriction in asthmatic children: comparison of two doses

Cold air-provoked respiratory symptoms: the mechanisms and management

Effect of chronic theophylline treatment on the methacholine dose-response curve in allergic asthmatic subjects

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