Penny A. Hutson

Inhibition by nedocromil sodium of early and late phase bronchoconstriction and airway cellular infiltration provoked by ovalbumin inhalation in conscious sensitized guinea-pigs

Bronchial challenge of ovalbumin‐sensitized conscious guinea‐pigs induced a triphasic reduction in specific airways conductance (sGaw) with maximal reductions being observed at 2, 17 and 72 h. accompanied by infiltration of the airways with neutrophils at 17 h and eosinophils at 17 and 72 h. Nedocromil sodium (10 mg ml−1) inhaled before challenge blocked the 2 and 17 h sGaw responses and the neutrophil influx. When inhaled 6 h after challenge, nedocromil inhibited the 17 h sGaw response but not neutrophil influx, suggesting that these are unrelated. The sGaw response and eosinophil accumulation at 72 h was also inhibited by nedocromil given at this time. Our findings correlate with the clinical effects of nedocromil, suggesting the guinea‐pig model may be useful for investigating the mechanism of action of anti‐asthmatic drugs.

Allergy or inflammation? From neuropeptide stimulation of human skin mast cells to studies on the mechanism of the late asthmatic response

This short review examines two examples of studies into the mechanisms of allergic responses which have particular relevance to inflammation research. The first is the ability of human skin mast cells, but not those derived from lung, adenoids, tonsils or intestine, to release histamine in response to stimulation by neuropeptides including substance P, vasoactive intestinal polypeptide (VIP) and somatostatin. The neuropeptide activation site does not appear to be a classical tachykinin receptor but rather a binding site of low affinity and low specificity capable of interacting with neuropeptides and compounds with similar physicochemical characteristics. In contrast to IgE-dependent activation, neuropeptide stimulation of skin mast cells induces a rapid release of histamine with minimal generation of PGD2 and LTC4. This pseudo-allergic reaction is thought to underlie the weal and flare response in the skin and may have a role in urticaria. The second example describes studies to elucidate the mechanisms of the late asthmatic response by use of a guinea-pig model. As in man, both early and late phase responses in the guinea-pig are inhibited by sodium cromoglycate whereas only the early response is inhibited by theβ-adrenoceptor stimulant drug salbutamol. Examination of bronchoalveolar fluid has shown a temporal relationship between an airways neutrophilia and the late response. However, pharmacological manipulation and the use of an anti-neutrophil serum has shown that these events are not interdependent. The role of the airways eosinophilia requires further investigation.

Primary and Secondary Effector Cells in the Pathogenesis of Bronchial Asthma

The immediate and late asthmatic reactions provoked by inhaled allergens have provided useful models enabling the dissection of individual inflammatory cells and their mediators that may contribute to the pathogenesis of asthma. The immediate reaction is considered to be mast cell-mediated on the basis that about 50% of the response is inhibitable by potent and selective H1-receptor antagonists such as terfenadine and astemizole. Additional inhibition (approximately 30%) by the potent cyclooxygenase inhibitor flurbiprofen implies an important role for prostanoids in the immediate response, the most likely mast cell-derived product being prostaglandin (PG) D2. In man, PGD2 is selectively metabolised to 9 alpha 11 beta-PGF2, a unique prostaglandin which shares with PGD2 contractile properties on guinea-pig and human airways smooth muscle. The inability of piriprost, a potent leukotriene synthesis inhibitor, to influence the allergen-provoked immediate reaction raises the possibility that sulphidopeptide leukotrienes play a minor role in this response. The late asthmatic reaction is considered to resemble clinical asthma since it is accompanied by increased responsiveness of the airways to a wide range of stimuli. The late reaction in man is inhibited by nedocromil sodium (4 mg) but only marginally attenuated by salbutamol (200 micrograms) if both drugs are administered prior to allergen challenge. Since salbutamol, in the dose administered, is a potent mast cell-stabilising agent, these findings must question the obligatory role of mast cell mediator release in the pathogenesis of the late response.(ABSTRACT TRUNCATED AT 250 WORDS)

Nedocromil sodium blocks the early and late phases of allergen challenge in a guinea pig model of asthma

We developed a model of asthma in conscious guinea pigs in which both early- and late-phase reductions in specific airways conductance are demonstrable after inhalation challenge. Neutrophilia that peaks 17 hours after challenge was discovered by bronchoalveolar lavage in this model, as was eosinophilia that develops more slowly, peaking at 72 hours. Nedocromil sodium blocked both the early- and late-phase reductions in airflow, but salbutamol blocked only the early phase. Both drugs blocked the neutrophilia when given before challenge, but not when given 6 hours afterward. This suggests that the neutrophila is secondary to an intact early phase response. Nedocromil sodium, given 6 hours after challenge, reduced the eosinophilia at 72 hours but not at 17 hours. Salbutamol had no effect on the eosinophilia at either time. These results suggest that nedocromil sodium has antiinflammatory properties in the lung that are not shared by the beta 2-adrenergic stimulant drug, salbutamol.

Effect of Nedocromil Sodium on Early and Late Phase Responses to Allergen Challenge in the Guinea-Pig

SummaryWe have developed a model of asthma in conscious guineapigs in which inhalation challenge with specific allergen induces both early and late phase reductions in specific airways conductance. Analysis of cells removed from the airways by bronchoalveolar lavage showed the presence of a neutrophilia, which reached a maximum at 17 hours, and an eosinophilia which developed more slowly, still increasing at 72 hours. Nedocromil sodium inhaled before challenge inhibited both the early and late phase responses. In contrast, the β-adrenoceptor stimulant, salbutamol, inhibited only the early phase. When inhaled 6 hours after challenge, i.e. between the early and late phase responses, the late phase bronchoconstriction was prevented by nedocromil sodium but only partially by salbutamol. Evidence that the neutrophilia was not functionally associated with the late response was gained from the observations that it was inhibited by both nedocromil sodium and salbutamol, whereas only nedocromil sodium blocked the late phase airways response. When administered 6 hours after challenge, nedocromil sodium reduced eosinophil accumulation at 72 hours in parallel with inhibiting a secondary late response at this time. These results demonstrate that nedocromil sodium is able to prevent both early and late phase reductions in airways function in an animal model of allergic asthma. Whereas inhibition of the early response may reflect an effect on mast cell mediator release, the effects of nedocromil sodium on the late response and on eosinophil accumulation are strongly suggestive of an anti-inflammatory effect within the lung.