Bronchial, alveolar, and vascular-induced anaphylaxis and irritant-induced cardiovascular and pulmonary responses.

We examine the respiratory, bronchomotor, cardiac, and vascular responses to histamine and ragweed allergen delivered to the bronchi or alveoli compartments and the potential role of sensory nerves and reflexes mediating the histamine-induced responses. The masses of aerosols deposited in the bronchi and alveoli were quantitated using radioaerosol techniques. Activation of sensory nerves and/or histamine-induced mediator release were characterized by depositing nedocromil sodium aerosol prior to histamine challenge. The histamine-induced responses due to vagosympathetic transmission were determined by performing bilateral vagotomy. Both histamine and ragweed increased respiratory rate, ventilation, and bronchomotor tone whether deposited in the bronchial or alveolar regions. However, these responses were not elicited when histamine was administered intravenously. Precipitous allergen-induced decreases in heart rate and systolic and diastolic pressure were maximal 72 sec following ragweed deposition in alveolar regions of the lungs. Increases in respiratory rate were mediated via the vagus whether delivered to the bronchi, alveoli, or vasculature. Histamine-induced increases in respiratory rate and bronchomotor tone were attenuated by nedocromil. When histamine was delivered to the alveolar regions, increases in lung resistance appeared to be mediated primarily via the vagus and when delivered to the bronchial airways primarily by its action on smooth muscle or local reflexes. Histamine-induced hypotension and bradycardia appear to be mediated by the direct action of histamine on the cardiovascular system rather than through a vagally mediated reflex.

Bronchial and alveolar allergen-induced anaphylaxis and the stimulation of bronchial mucociliary clearance in ragweed-sensitized dogs.

In allergic airways disease, we hypothesized that an acute allergen inhalation activates cells in the bronchial and alveolar regions of the lungs to initiate cardiopulmonary anaphylactic responses that include the stimulation of bronchial mucociliary clearance. Seven beagles were neonatally sensitized to ragweed allergen, and four were sham-sensitized. Adult dogs were anesthetized with propofol and etomidate. Bronchial retention of radiotagged particles deposited in the lungs was monitored with a gamma camera. Then 0.4-1.8 micrograms of ragweed allergen was deposited either proximally or peripherally in the lungs while achieving a similar total mass deposited. Both proximal and peripheral allergen deposition elicited cardiopulmonary responses characteristic of anaphylaxis. Following proximal allergen deposition, the mean bronchial mucuciliary clearance at 60 min increased from 27.5% +/- 4.9% to 59.9% +/- 3.3% (p < .01), and following peripheral deposition it increased from 5.9% +/- 3.1% to 52.9% +/- 7.2% (p < .01). No allergen-induced suppression of bronchial mucociliary clearance was detected within the 140-min postexposure period. No changes in cardiopulmonary responses or bronchial mucociliary clearance in the unsensitized dogs could be ascribed to the inhalation of allergen. Both the bronchi and alveoli are target sites for the initiation of allergen-induced respiratory and cardiovascular anaphylactic responses and the stimulation of bronchial mucociliary clearance.

Lung mucociliary transport in asymptomatic asthma: effects of inhaled histamine.

Bronchial mucociliary clearance (CB) and tracheal mucus velocity (TMV) were measured during the course of repeated inhalations of histamine in six subjects with asthma who had no symptoms in a double-blind, crossover study with a radioaerosol technique. Subjects inhaled a technetium 99m-labeled ferric oxide aerosol with an aerodynamic diameter of approximately 8 microns. CB was recorded for 2.5 hours with a gamma camera, and TMV measured with a multidetector probe situated over the extrathoracic trachea. Histamine was administered repeatedly in concentrations previously shown to produce a 20% fall in forced expired volume in 1 second and at intervals allowing 90% recovery of pulmonary function. Histamine produced a 28% increase in CB (p less than 0.001, analysis of variance) and an 87% increase in TMV (p less than 0.001, analysis of variance) above control values, which was not significantly different from that previously observed in normal subjects receiving significantly higher concentrations of histamine. We conclude that histamine stimulates the mucus transport mechanism in subjects with asthma and that there is a relative hypersensitivity to histamine when these subjects are compared with normal subjects.

The effect of inhaled histamine on human tracheal mucus velocity and bronchial mucociliary clearance.

The effect of inhaled histamine on human tracheal mucus velocity (TMV) and bronchial mucociliary clearance (CB) was investigated in six healthy subjects using radioaerosol techniques in a randomized double-blind crossover study. Subjects inhaled repeated doses of either phosphate-buffered saline (PBS) or histamine, immediately after the inhalation of a radioaerosol and during the subsequent 2.5-h clearance measurements. Histamine was administered in concentrations previously demonstrated to induce a 20% fall in FEV1 at intervals permitting 90% recovery (mean recovery time = 25 min). Both TMV and CB were significantly increased by inhaled histamine (p less than 0.001). Average TMV throughout the 2.5-h studies increased from 4.9 +/- 1.3 to 8.4 +/- 1.6 mm/min. The increase in TMV above control values became apparent from 5 to 20 min after the first histamine administration. The percentage of aerosol clearance in 60 min increased 33%. The enhancement of CB became statistically significant at 21 min and persisted throughout the 2.5-h measurements (p less than 0.05). The increase in CB could not be attributed to differences in aerosol deposition because measurements of aerosol penetration were not significantly different between PBS and histamine studies. These data indicate that the bronchoconstriction caused by histamine is accompanied by an increase in tracheal and bronchial mucus transport. Release of histamine, as part of an inflammatory response, may alter mucociliary clearance in humans.