Interaction between bronchoconstrictor stimuli on human airway smooth muscle

In healthy human subjects, the simultaneous aerosol administration of histamine and methacholine results in a pronounced decrease in maximum flow rates on partial expiratory flow-volume (PEFV) curves. When given alone in the same concentrations, these drugs produced no or minimal decreases in flow rates. The results suggest an interaction of histamine and cholinergic stimuli on airway smooth muscle (ASM). This mechanism might explain many experiments where vagal blockade diminished or abolished ASM response to histamine and other stimuli, simply by interfering with histamine-cholinergic interaction at the ASM level. These findings confirm similar findings of animal in vitro experiments. The experiments clearly confirm the sensitivity and value of assessing drug effects prior to a deep breath. Flow-rate changes after a full inspiration, taken from the maximum expiratory flow-volume (MEFV) curve, show either no relationship to the concentration of inhaled methacholine or significantly less effect than that seen on the PEFV curve.