Local application of atropine attenuates the upper airway reaction to cold, dry air.
Local application of atropine attenuates the upper airway reaction to cold, dry air.
复制标题
局部应用阿托品可减轻上呼吸道对寒冷、干燥空气的反应。
DOI：
10.1164/ajrccm/146.2.340
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发表时间：
1992
期刊：
影响因子：
--
通讯作者：
Naclerio,RM
中科院分区：
文献类型：
--
作者：
Cruz,AA;Togias,AG;Lichtenstein,LM;Kagey-Sobotka,A;Proud,D;Naclerio,RM
在一些人中，吸入冷干空气(CDA)会引发鼻炎症状，并伴有炎性介质水平和恢复的鼻腔灌洗液的血浆渗漏标志物水平的增加。因为鼻漏是这种反应的主要成分，而且鼻腺受到副交感神经系统的严重支配，我们评估了阿托品对CDA鼻部反应的影响。采用双盲、随机、交叉设计，我们在18名志愿者接受CDA刺激前，鼻内给予总剂量为0.5毫克的阿托品或安慰剂。用症状评分和测定激发前、后灌洗液中组胺、N-α-对甲苯磺酰-L甲酯(TAME)活性、白蛋白、渗透压等指标监测反应。阿托品可显著减少鼻漏、组胺水平、驯化酯酶活性以及回收灌洗液的渗透压，但对鼻塞和白蛋白没有影响。然而，即使使用阿托品，鼻漏和驯化酯酶活性仍显著高于激发前基线。我们的结果表明，阿托品敏感的副交感神经传出通路参与了CDA诱导的鼻炎。我们推测：(1)上呼吸道对干燥空气反应的腺体和血管事件具有不同的病理生理机制；(2)灌洗液中驯化酯酶活性的一个重要组成部分可能起源于腺体；(3)除副交感神经外，上呼吸道对干燥空气的反应还涉及其他机制。导致组胺减少的机制(S)尚不清楚。
In some individuals, inhalation of cold, dry air (CDA) provokes symptoms of rhinitis, accompanied by an Increase in the levels of Inflammatory mediators and markers of plasma leakage of recovered nasal lavages. Because rhinorrhea Is a major component of this reaction and because nasal glands are heavily Innervated by the parasympathetic system, we assessed the effect of atropine on the nasal reaction to CDA. Using a double-blind, randomized, crossover design, we administered a total dose of 0.5 mg of atropine or placebo Intranasally to 18volunteers before provocation with CDA. The reaction was monitored with symptom scores and by measuring the concentrations of histamine, N-alpha-p-tosyl-L-arglnlne methyl ester (TAME)-esterase activity and albumin, as well as the osmolality of lavage fluids before and after the provocation. Atropine significantly reduced rhinorrhea, the levels of histamine, and TAME-esterase activity as well as the osmolality of recovered lavage fluids, but had no effect on nasal congestion or albumin. Even with atropine, however, rhinorrhea and TAME-esteraseactivity were stili significantly Increasedover the prechallenge baseline. Our results demonstrate that atropine-sensitive parasympathetic efferent pathways contribute to the CDA-Induced rhinitis. We speculate that (1) the glandular and the vascular events of the upper airway reaction to dry air have different pathophysiologic mechanisms;(2) a significant component of TAME-esterase activity In lavage fluids may be of glandular origin; and (3) In addition to parasympe: thetlc nerve activation, other mechanisms are Involved In the upper airway reaction to dry air. The mechanlsm (s) leading to the reduction of histamine Is unknown.