Tohoku
J. exp.
Med.,
1979, 127,
197-198
Short
Effects
of Adrenergic
Immediate
Agonists
Cutaneous
and
Reactions
Report
Antagonists
on
in Bronchial
Asthma TETSUHIRO OHMI, SUETSUGU MUE, MAKOTO TAKAHASHI, SHIGEKI SHIBAHARA, K.OHEI YAMAUCHI, GEN TAMURA, SATORU FUJIMOTO, HWEI CHU CHEN* and TAMOTSU TAKISHIMA
The First Department of Internal Medicine and *Department of Pediatrics, Tohoku University School of Medicine, Sendai 980
OHMI, T., MUE, S., TAKAHASHI,M., SHIBAHARA,S., YAMAUCHI,K., TAMURA, G., FUJIMOTO, S., CHEN, H.C. and TAKISHIMA,T. Effects of Adrenergic Agonists and Antagonists on Immediate Cutaneous Reactions in Bronchial Asthma. Tohoku J. exp. Med., 1979, 127 (2), 197-198 Asthmatic patients who showed an allergic skin reaction to house-dust antigen (HD) were injected intradermally with a mixture of HD and a various dose of isoproterenol (Isopr) or propranolol (Propr). In some cases Isopr clearly suppressed the formation of the wheal, but in some others Isopr did not much affect the allergic skin reaction. Also Propr increased markedly the skin reaction of some patients, or had little effect on it. The sensitivity of the skin of asthmatic patients to these drugs was closely correlated with the general response of the patients to adrenaline, such as changes in heart rate, diastolic blood pressure, blood glucose level, and blood triglyceride level. adrenergic drugs; skin and systemic response; asthma Imbalance of the autonomic nervous system has been cited as one of the etiological factors in bronchial asthma (Cookson and Reed 1963; Shereff et a]. 1973). The present study was undertaken to see whether such imbalance was corroborated in the skin of asthmatic patients by observing the effects of adrenergic agonists and antagonists on antigen-induced
intradermal
Asthmatic (HD)
patients
received
an
propranolol to skin
It
reaction Then,
HD
and
with
The
of skin
in
the
drugs
and
(positive,
was
the
of
physiological assessed
10
of
"I")
as
"P")
out
for publication,
and
exerted
saline
by
of
by 75
diameter by
July
less
HD
at
the
more
an
(•~2000
HD)
with by
more
the
than effect
of
wheal
than
20%
27, 1978. 197
marked of
the
the
20% of
Isopr
6 was
at 42
62
least
(negative,
on and
of•~1000 HD
diluted
performed,
and
min
after
effect
of
Isopr
75
of
50%
One ƒÊg in
expressed
25
10 ƒÊg HD
(defined
expressed
doubtful.
the
injection.
with
patients
(negative,
0
allergic
antigen.
concomitant
of
of
from
the
mixture
15
MM)
in
by in
also
control
in
a
2 ƒÊg
time
of•~1000
adrenergic
50%
of
drug
of
was
the
antigen or
effects
injection
(2.0•~10-4
than
less
intervals
injection
control
Isopr
house-dust (Isopr)
various
injections
comparing
to
isoproterenol
intradermal As
of
reaction
of
between an
Propr.
and
ng
of•~1000
drugs
ng
wheal
the
20
suppressed
of
as
ml
by
completely
increased
expressed
or
allergic
of
gave
Isopr
7 patients
mM)
positive
interval
we
of
diameter
expressed
0.02 these
study
injection
remaining
Received
was
by that
were
reaction
the
the
next
volume
diminished
(3.4•~10-1
shorter
the
same
An
In
the
doses
more.
positive
observed
a
injection
followed
various
the
effects
or
was
showed
intradermal
(Propr),
4 hr.
reactions.
who
of
85
as
"P").
as
as
"i").
of
Propr
patients The
198
T. Ohmi
et a].
effect of Propr was doubtful in the remaining 18 patients. The effect of the adrenergic drugs on the allergic skin reactions was so much variable in asthmatic patients that we classified the skin sensitivities to adrenergic drugs into 4 types as follows: I-P (the effects of both Isopr and Propr were positive); I-p (Isopr suppressed the skin reaction but Propr gave a negative effect); i-P (Isopr gave a negative effect on the wheal but Propr increased the skin reaction); i-p (neither Isopr nor Propr was effective). In
the
drugs
third
and
Changes
the of
heart
triglyceride (0.2 ƒÊg/kg
of
by
of asthmatic
positive
responses, whose
response.
On
a negative
(-) was
beta-adrenergic
with
the the
of
and
(-) sensitivity
other
three
by
response
of
the
than score
was
the
I-P who
autonomic
nervous
to system
be
than
a
positive into
antagonist vessels
and
, (•})
three
of
(+) i-p
to
adrenaline
showed
reaction show
blood
drugs
2
four
adrenaline
group
skin
tended
adrenergic
responses
1,
whose
HR
, BG response
responses
Table
the
if 15%
adrenaline adrenergic
in
autoby
positive
more
classified
to
Technicon
3 positive
shown
blood
estimated
The
patients
blood
patients
or
showed
or
peripheral
asthmatic
4
were
asthmatic
agonist
by
20%.
and
hydrochloride a
to
these
patients.
(BG)
was
of 4 positive
(+) As
patients is,
heart, of
the
by
decreased
more
follows:
drugs
adrenaline
considered
response.
adrenergic
the
skin
the
that
either of
of the
to
positive
glucose
of
BT
to
asthmatic
blood
and
dBP by
sensitivities in
determined
was
line,
as
of four
response;
responses
general
base increased
to
hand,
affected
sensitivity
the BT
0
was fluoride
according
1 or
(dBP),
adrenaline
measurements
adrenaline not
of and
classified
types
skin the
15%
skin
adrenaline
injection
sodium
of
the
to
pressure
glucose
of
effect
60%, was
four
patients
Thus,
than
patients
above
antigen
The
between
intravenous
Blood
addition
than
more
blood after
weight/min).
more
by
relation response
diastolic
measured
method.
increased
the
cardio-vascular
(HR),
immediate
acetylaceton increased
examined
and
were
body
after
the
we
rate
(BT)
analyzer
in
study metabolic
is well
to
reduced
metabolism
.
correlated
.
TABLE1. Metabolic responses to adrenaline in different skin types classified according to the sensitivity to isoproterenoland propranolol
Figures A, HD;
patients a,
patients
show
the numbers
of patients.
who
showed
a
positive
skin
reaction
to •~
who
showed
a
negative
skin
reaction
to•~2000
2000
HD.
References
1)
Cookson, D. & Reed, C. (1963) A comparison of the effects of i soproterenol in the normal and asthmatic subject. Amer. Rev . resp. Dis., 88, 636-643 .2) Sh ereff, R., Harwell, W., Lieberman , P., Rosenberg, W. & Robinson , H. (1973) of beta Effect adrenergic stim ulation and blockade on immediate hypersensitivit y skin reactions. J. Allerg . clin. Immunol., 52, 328-333 .
J. exp.
Med.,
1979, 127,
197-198
Short
Effects
of Adrenergic
Immediate
Agonists
Cutaneous
and
Reactions
Report
Antagonists
on
in Bronchial
Asthma TETSUHIRO OHMI, SUETSUGU MUE, MAKOTO TAKAHASHI, SHIGEKI SHIBAHARA, K.OHEI YAMAUCHI, GEN TAMURA, SATORU FUJIMOTO, HWEI CHU CHEN* and TAMOTSU TAKISHIMA
The First Department of Internal Medicine and *Department of Pediatrics, Tohoku University School of Medicine, Sendai 980
OHMI, T., MUE, S., TAKAHASHI,M., SHIBAHARA,S., YAMAUCHI,K., TAMURA, G., FUJIMOTO, S., CHEN, H.C. and TAKISHIMA,T. Effects of Adrenergic Agonists and Antagonists on Immediate Cutaneous Reactions in Bronchial Asthma. Tohoku J. exp. Med., 1979, 127 (2), 197-198 Asthmatic patients who showed an allergic skin reaction to house-dust antigen (HD) were injected intradermally with a mixture of HD and a various dose of isoproterenol (Isopr) or propranolol (Propr). In some cases Isopr clearly suppressed the formation of the wheal, but in some others Isopr did not much affect the allergic skin reaction. Also Propr increased markedly the skin reaction of some patients, or had little effect on it. The sensitivity of the skin of asthmatic patients to these drugs was closely correlated with the general response of the patients to adrenaline, such as changes in heart rate, diastolic blood pressure, blood glucose level, and blood triglyceride level. adrenergic drugs; skin and systemic response; asthma Imbalance of the autonomic nervous system has been cited as one of the etiological factors in bronchial asthma (Cookson and Reed 1963; Shereff et a]. 1973). The present study was undertaken to see whether such imbalance was corroborated in the skin of asthmatic patients by observing the effects of adrenergic agonists and antagonists on antigen-induced
intradermal
Asthmatic (HD)
patients
received
an
propranolol to skin
It
reaction Then,
HD
and
with
The
of skin
in
the
drugs
and
(positive,
was
the
of
physiological assessed
10
of
"I")
as
"P")
out
for publication,
and
exerted
saline
by
of
by 75
diameter by
July
less
HD
at
the
more
an
(•~2000
HD)
with by
more
the
than effect
of
wheal
than
20%
27, 1978. 197
marked of
the
the
20% of
Isopr
6 was
at 42
62
least
(negative,
on and
of•~1000 HD
diluted
performed,
and
min
after
effect
of
Isopr
75
of
50%
One ƒÊg in
expressed
25
10 ƒÊg HD
(defined
expressed
doubtful.
the
injection.
with
patients
(negative,
0
allergic
antigen.
concomitant
of
of
from
the
mixture
15
MM)
in
by in
also
control
in
a
2 ƒÊg
time
of•~1000
adrenergic
50%
of
drug
of
was
the
antigen or
effects
injection
(2.0•~10-4
than
less
intervals
injection
control
Isopr
house-dust (Isopr)
various
injections
comparing
to
isoproterenol
intradermal As
of
reaction
of
between an
Propr.
and
ng
of•~1000
drugs
ng
wheal
the
20
suppressed
of
as
ml
by
completely
increased
expressed
or
allergic
of
gave
Isopr
7 patients
mM)
positive
interval
we
of
diameter
expressed
0.02 these
study
injection
remaining
Received
was
by that
were
reaction
the
the
next
volume
diminished
(3.4•~10-1
shorter
the
same
An
In
the
doses
more.
positive
observed
a
injection
followed
various
the
effects
or
was
showed
intradermal
(Propr),
4 hr.
reactions.
who
of
85
as
"P").
as
as
"i").
of
Propr
patients The
198
T. Ohmi
et a].
effect of Propr was doubtful in the remaining 18 patients. The effect of the adrenergic drugs on the allergic skin reactions was so much variable in asthmatic patients that we classified the skin sensitivities to adrenergic drugs into 4 types as follows: I-P (the effects of both Isopr and Propr were positive); I-p (Isopr suppressed the skin reaction but Propr gave a negative effect); i-P (Isopr gave a negative effect on the wheal but Propr increased the skin reaction); i-p (neither Isopr nor Propr was effective). In
the
drugs
third
and
Changes
the of
heart
triglyceride (0.2 ƒÊg/kg
of
by
of asthmatic
positive
responses, whose
response.
On
a negative
(-) was
beta-adrenergic
with
the the
of
and
(-) sensitivity
other
three
by
response
of
the
than score
was
the
I-P who
autonomic
nervous
to system
be
than
a
positive into
antagonist vessels
and
, (•})
three
of
(+) i-p
to
adrenaline
showed
reaction show
blood
drugs
2
four
adrenaline
group
skin
tended
adrenergic
responses
1,
whose
HR
, BG response
responses
Table
the
if 15%
adrenaline adrenergic
in
autoby
positive
more
classified
to
Technicon
3 positive
shown
blood
estimated
The
patients
blood
patients
or
showed
or
peripheral
asthmatic
4
were
asthmatic
agonist
by
20%.
and
hydrochloride a
to
these
patients.
(BG)
was
of 4 positive
(+) As
patients is,
heart, of
the
by
decreased
more
follows:
drugs
adrenaline
considered
response.
adrenergic
the
skin
the
that
either of
of the
to
positive
glucose
of
BT
to
asthmatic
blood
and
dBP by
sensitivities in
determined
was
line,
as
of four
response;
responses
general
base increased
to
hand,
affected
sensitivity
the BT
0
was fluoride
according
1 or
(dBP),
adrenaline
measurements
adrenaline not
of and
classified
types
skin the
15%
skin
adrenaline
injection
sodium
of
the
to
pressure
glucose
of
effect
60%, was
four
patients
Thus,
than
patients
above
antigen
The
between
intravenous
Blood
addition
than
more
blood after
weight/min).
more
by
relation response
diastolic
measured
method.
increased
the
cardio-vascular
(HR),
immediate
acetylaceton increased
examined
and
were
body
after
the
we
rate
(BT)
analyzer
in
study metabolic
is well
to
reduced
metabolism
.
correlated
.
TABLE1. Metabolic responses to adrenaline in different skin types classified according to the sensitivity to isoproterenoland propranolol
Figures A, HD;
patients a,
patients
show
the numbers
of patients.
who
showed
a
positive
skin
reaction
to •~
who
showed
a
negative
skin
reaction
to•~2000
2000
HD.
References
1)
Cookson, D. & Reed, C. (1963) A comparison of the effects of i soproterenol in the normal and asthmatic subject. Amer. Rev . resp. Dis., 88, 636-643 .2) Sh ereff, R., Harwell, W., Lieberman , P., Rosenberg, W. & Robinson , H. (1973) of beta Effect adrenergic stim ulation and blockade on immediate hypersensitivit y skin reactions. J. Allerg . clin. Immunol., 52, 328-333 .
