Multiple mechanisms of xanthine actions on airway reactivity

Xanthines are effective in the treatment of asthma, but the mechanism of action remains unclear. Pulmonary effects of seven xanthines, exhibiting a range of potencies as cyclic nucleotide phosphodiesterase (PDE) inhibitors and as adenosine antagonists, were investigated in anesthetized and ventilated guinea pigs. The bronchodilator effects of xanthines, determined from reversal of bronchoconstriction induced by aerosols of histamine and carbachol, correlated with their relative potencies as cyclic AMP-PDE inhibitors. The hypotensive effects of xanthines at bronchodilator doses were also consistent with PDE inhibition. Prophylactic effects of xanthines against bronchoconstriction induced by an aerosol of ovalbumin in sensitized guinea pigs, or by aerosols of leukotriene D4 and platelet-activating factor (PAF) in normal guinea pigs, occurred by a mechanism unrelated to bronchodilation and could not be readily attributed to PDE inhibition or adenosine A1/A2 receptor antagonism. There was a close association between inhibition of the responses to antigen and leukotriene D4, suggesting a common mechanism of action, but these effects gave a different profile from inhibition of the response to PAF. In addition, PAF-induced hypotension was unaffected in animals in which PAF-induced bronchoconstriction was inhibited, suggesting a mechanism other than PAF receptor antagonism. These results indicate that the bronchodilator, antiallergic and anti-inflammatory effects of xanthines occur through multiple molecular mechanisms of action, including at least one unknown mechanism. Furthermore, 8-phenyltheophylline produces these prophylactic effects at a dose that does not produce the cardiovascular or emetic side effects associated with xanthines, thereby exhibiting unique characteristics of potential therapeutic importance.