Late asthmatic responses

Single dose or short-term treatment with aerosolized steroids inhibits both the late asthmatic response and allergen-induced bronchial hyperresponsiveness (45,92). However it does not affect the early asthmatic response nor does it induce bronchodilation (45,92). Long-term treatment with steroids protects against both the early and late asthmatic responses and also reduces bronchial hyperresponsiveness (44,71,86,93). Over time, the airways relax (dilate) and measures of airway function, such as forced expiratory volume in one second (FEV ), gradually return to almost normal levels. 

Leckie MJ, ten Brinke A, Khan J, et al. Effects of an interleukin-5 blocking monoclonal antibody on eosinophils, airway hyper-responsiveness, and the late asthmatic response. Lancet 2000 356(9248) 2144-2148. 

Late asthmatic response to inhaled antigen Steroids, other anti-inflammatories... 

Chronic exposure to fumes of heated glacial acetic acid in a canning factory has been associated with a late airway response resulting in chronic inflammation and severe bronchial asthma. Inhalation challenge induced a late asthmatic response, confirming sensitization. ... 

Kivity S, Fireman E, Lerman Y Late asthmatic response to inhaled glacial acetic acid. Thorax 49(7) 727-8, 1994... 

Mechanism of Action A mast cell stabilizer that prevents the activation and release of inflammatory mediators, such as histamine, leukotrienes, mast cells, eosinophils, andmonocytes.T herapeuticEffect Prevents both early and late asthmatic responses. Pharmacokinetics The extent of absorption is 7% to 9% of a single inhaled dose of 3.5 to 4 mg and 17% of multiple inhaled doses, with absorption largely from the respiratory tract. Although most of the inhaled dose is subsequently swallowed, only 2% to 3% is absorbed from the G1 tract. Less than 4% of the total dose is systemically absorbed following multiple doses of ophthalmic solution. Protein binding 89%. Not metabolized. Excreted in urine. Half-life 1.5-3.3 hr. 

Robertson DG, Ketigan AT, Hargreave FE, Chalmers R, et al. 1974. Late asthmatic responses induced by ragweed pollen allergen. J All Clin Immunol. 54 244-254. 

Lai CK, Twentyman OP, Holgate ST. The effect of an increase in inhaled allergen dose after rimiterol hydrobromide on the occurrence and magnitude of the late asthmatic response and the associated change in nonspecific bronchial responsiveness Am Rev Respir Dis 1989 140(4) 917-23. 

Cockcroft DW, O Byrne PM, Swystun VA, Bhagat R. Regular use of inhaled albuterol and the allergen-induced late asthmatic response. J Allergy Clin Immunol 1995 96(l) 44-9. 

Cartier, A., Thomson, N.C., Frith, P.A., Roberts, R and Har-greave, F.E. (1982). Allergen-induced increase in bronchial responsiveness to H relationship to the late asthmatic response and change in airway calibre. J. Allergy Clin. Immunol. 70, 170-177. 

Nakamura, T., Morita, Y., Kuriyama, M., Ishihara, K., Ito, K. and Miyamoto, T. (1987). Platelet activating fector in late asthmatic responses. Int. Arch. Allergy Appl. Immunol. 82, 57-61. 

Ohrui, T., Sekizawa, K., Aikawa, T., Yamauchi, K., Sasaki, H. and Takashima, T. (1992). Vascular permeability and airway narrowing during late asthmatic response in dogs treated with metopirone. J. Allergy Clin. Immunol. 89, 933-943. 

Inhibits degranulation of mast cells also inhibits release of histamine and SRS-A (a leukotriene) from the mast cell. This inhibits the early asthmatic response by stabilizing the mast cell also inhibits the late asthmatic response. It has no intrinsic bronchodilator, antihistaminic, anticholinergic, vasoconstrictor, or anti-inflammatory activity. 

Thromboxane A2 is produced by alveolar macrophages, fibroblasts, epithelial cells, neutrophils, and platelets within the lung. Indirect evidence from animal models suggests that thromboxane A2 may have several effects, including bronchoconstriction, involvement in the late asthmatic response, and involvement in the development of airway inflammation and BHR. Potent and specific thromboxane synthetase inhibitors will be crucial tools for understanding the role of thromboxanes in asthma. 

Inflammatory disease associated with bronchial hyperactivity (BHR), bronchospasm, T mucus secretion, edema, and cellular infiltration. Early asthmatic responses (EAR) lasting from 30 to 60 min are associated with bronchospasm from the actions of released histamine and leukotrienes late asthmatic responses (LAR) involve infiltration of eosinophils and lymphocytes into airways - > bronchoconstriction and inflammation with mucus plugging. 

DURHAM, S.R., GRANEEK, B.J., HAWKINS, R. NEWMAN TAYLOR, A.J. (1987) The temporal relationship between increases in airway responsiveness to histamine and late asthmatic responses induced by occupational agents. Journal of Allergy and Clinical Immunology, 79, 398 106. 

The Late Asthmatic Response as a Model for Clinical Asthma... 

---