Source: Annual Congress 2002 - Aspects of respiratory disease in primary care
Disease area: Airway diseases

Abstract

Prostaglandin E is considered to play a pivotal role in the control of bronchoconstriction in aspirin-induced asthma. However, little information is available on the effect of the other cyclooxygenase product, prostacyclin. We investigated the effect of inhalation of the prostacyclin analogue, iloprost, on bronchoconstriction induced by inhaled lysine acethylsalicylate (L-ASA) in aspirin-sensitive asthma. We studied 6 patients with aspirin-induced asthma in stable clinical condition, 3 males and 3 females, mean age 43 ±]4 yrs (M ±]SE)., FEV1 91 ±]5% of predicted. Each subject performed two bronchial challenges, with an interval of 7-10 days, using a single dose of L-ASA which had caused a 20% decrease in FEV1 in a preliminary dose-response challenge. The challenges were performed immediately after inhalation of iloprost 20 μg in 3 ml or placebo, according to a randomized, double-blind protocol. Both treatments were well tolerated. Respiratory function was recorded before and after treatment and at 30' intervals up to four hours after challenge. All the subjects presented an asthmatic response after placebo, peaking usually at 90', with a mean maximum decrease in FEV1 of 26 ±]4% with respect to baseline value. After iloprost, the aspirin-induced asthmatic response was significantly attenuated at all time points with a maximum fall in FEV1 of 4 ±]4% of baseline, corresponding to a degree of protection of 79 ±]14%. We conclude that inhaled iloprost provides protective activity against L-ASA-induced bronchoconstriction and that endogenous prostacyclin may play a protective role in aspirin-sensitive asthma.

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R. R. Metella, A. Roberta, C. Giuseppina, P. G. Maria, R. Maria, S. Piersante (Siena, Monza, Italy). Protective effect of inhaled iloprost on specific bronchial challenge in aspirin-sensitive asthma. Eur Respir J 2002; 20: Suppl. 38, 2975

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