The effect of antihistamine, endothelin antagonist and corticosteroid prophylaxis on contrast media induced bronchospasm.
The effect of antihistamine, endothelin antagonist and corticosteroid prophylaxis on contrast media induced bronchospasm.
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DOI：
10.1259/bjr.72.863.10700821
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发表时间：
1999-11
期刊：
影响因子：
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通讯作者：
E. Laude;C. Emery;S. Suvarna;S. Morcos
中科院分区：
文献类型：
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作者：
E. Laude;C. Emery;S. Suvarna;S. Morcos
支气管痉挛是公认的放射造影剂（RCM）的不良反应，在哮喘和特应性疾病中更常发生。本研究旨在确定最可能引起支气管痉挛的RCM，并探讨介导这种反应的潜在机制。用Hypnorm （5 ml kg-1）和Hypnovel （2 ml kg-1）麻醉豚鼠（平均体重550 g， n = 46），并引入气管、颈静脉和胸膜插管。总气道阻力（Raw）由压力/流量关系的斜率计算。研究了RCM（分散物370mgi ml-1，碘草酸酯320 mgI ml-1，碘曲兰300 mgI ml-1和碘丙胺300 mgI ml-1）以4ml kg-1体重剂量或与体积、pH和渗透压相匹配的对照溶液经颈静脉给药对Raw的影响。观察抗组胺药（Mepyramine, 30 mg kg-1 i.p）或非选择性内皮素受体拮抗剂（SB209670, 1 mg kg-1 i.v）预处理（RCM给药前30 min）的效果。还评估了皮质类固醇预防（强的松龙（20mg kg-1 i.p））给药18-24小时和rcm前1小时的有效性。对照动物在给药前接受生理盐水预处理。给药后30-40分钟取肺进行组织学检查。只有ioxagate导致Raw （5.19 +/- 0.58 ~ 13.95 +/- 3.53 mmHg ml-1 min-1）显著升高（p < 0.05）。甘露醇和生理盐水对照溶液对Raw没有任何影响。Mepyramine， SB209670或泼尼松龙预处理对ioxagate诱导的Raw升高没有显著影响。ioxagate治疗动物肺组织的组织学检查未见明显异常。综上所述，只有离子二聚物ioxagate引起Raw的增加。这种效果与渗透压无关，可能是造影剂化学成分的结果。它不是炎症反应，不能通过抗组胺药、内皮素拮抗剂或皮质类固醇的预防性治疗来预防。导致Raw增加的机制仍不确定。
Bronchospasm is a well recognized adverse reaction to radiographic contrast media (RCM) and may occur more frequently in asthmatics and atopics. This study was designed to identify RCM which are most likely to cause bronchospasm and to investigate underlying mechanisms mediating this response. Guinea pigs (mean body weight 550 g, n = 46) were anaesthetized with Hypnorm (5 ml kg-1) and Hypnovel (2 ml kg-1) and tracheal, jugular and pleural cannulae introduced. Total airways resistance (Raw) was calculated from the slope of the pressure/flow relationship. The effects of RCM (diatrizoate 370 mgI ml-1, ioxaglate 320 mgI ml-1, iotrolan 300 mgI ml-1 and iopromide 300 mgI ml-1) at a dose of 4 ml kg-1 body weight or control solutions matched for volume, pH and osmolarity administered via the jugular vein on Raw were studied. The effects of pre-treatment (30 min before the administration of RCM) with antihistamine (Mepyramine (30 mg kg-1 i.p.)) or non-selective endothelin receptor antagonist (SB209670 (1 mg kg-1 i.v.)) were investigated. The effectiveness of corticosteroids prophylaxis (prednisolone (20 mg kg-1 i.p.)) administered 18-24 h and 1 h pre-RCM was also assessed. Control animals received normal saline pre-treatment before RCM administration. Lungs were taken for histological examination 30-40 min post-administration of RCM. Only ioxaglate caused a significant (p < 0.05) increase in Raw (5.19 +/- 0.58 to 13.95 +/- 3.53 mmHg ml-1 min-1). Neither mannitol nor saline control solutions had any effect on Raw. Pre-treatment with Mepyramine, SB209670 or prednisolone caused no significant change in the ioxaglate induced increase in Raw. Histological examination of lung tissue from ioxaglate treated animals showed no important abnormalities. In summary, only the ionic dimer ioxaglate caused an increase in Raw. This effect was independent of osmolarity and could be the result of the chemical composition of the contrast agent. It was not an inflammatory response and could not be prevented by prophylactic treatment with antihistamine, endothelin antagonist or corticosteroids. The mechanisms responsible for the increase in Raw remain uncertain.