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Alpha-adrenergic hyper-responsiveness in asthma.

W R Henderson, J H Shelhamer, D B Reingold

    The New England Journal of Medicine
    |March 22, 1979
    PubMed
    Summary
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    Allergic asthma patients show heightened alpha-adrenergic responses compared to healthy individuals and those with allergic rhinitis. This suggests increased alpha-adrenergic activity may contribute to asthma development.

    Area of Science:

    • Pharmacology
    • Allergy and Immunology
    • Pulmonology

    Background:

    • Alpha-adrenergic stimulation is known to cause bronchoconstriction.
    • Understanding alpha-adrenergic responsiveness in allergic asthma is crucial for exploring disease mechanisms.

    Purpose of the Study:

    • To compare alpha-adrenergic responsiveness in subjects with allergic asthma, allergic rhinitis, and normal controls.
    • To investigate the role of phenylephrine in mediating responses in different subject groups.

    Main Methods:

    • Phenylephrine was used to measure alpha-adrenergic responsiveness by assessing its capacity to constrict the cutaneous vascular bed and dilate the pupillary sphincter muscle.
    • Participants included 21 subjects with allergic asthma, 16 with allergic rhinitis, and 38 normal controls, all medication-free for at least 30 days.

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    Main Results:

    • Asthmatic subjects required significantly less phenylephrine (4.0 ng) to reduce cutaneous blood flow by 50% compared to normal controls (32.0 ng) and allergic rhinitis subjects (23.7 ng).
    • Pupil dilation in asthmatic subjects occurred at a lower phenylephrine concentration (1.8%) compared to allergic rhinitis subjects (2.4%) and normal controls (2.7%).

    Conclusions:

    • Patients with allergic asthma exhibit significantly enhanced alpha-adrenergic responses.
    • Increased alpha-adrenergic activity is a potential contributing factor to the asthmatic diathesis and warrants further investigation.