E Ef ff fe ec ct t o of f i in nh ha al le ed d b br ra ad dy yk ki in ni in n o on n iin nd di ic ce es s o of f a ai ir rw wa ay y r re es sp po on ns si iv ve en ne es ss s i in n a as st th hm ma at ti ic c s su ub bj je ec ct ts s We have, therefore, investigated the effect of inhaled bradykinin on the changes in airway calibre and in airway hyperresponsiveness to histamine, in a double-blind, randomized study of nine asthmatic subjects. Subjects were studied on two study periods, separated by at least 15 days. On the first day of each study period, subjects inhaled either a single dose of bradykinin or methacholine (placebo) with changes in airway calibre being followed as forced expiratory volume in one second (FEV 1 ) and as the maximum expiratory flow rate measured at 70% of the vital capacity below total lung capacity (TLC) from a partial forced expiratory manoeuvre (Vp 30 ) Inhalation of bradykinin caused rapid bronchoconstriction that peaked at 3-5 min. When compared to placebo, no significant difference in histamine responsiveness was seen after bradykinin in terms of changes in PC 20 FEV 1 values. However, when airway hyperresponsiveness was measured as PC 40 Vp 30 , we were able to show a significant increase in airway reactivity after bradykinin at 3 and 7 h, the geometric mean PC 40 Vp 30 histamine value decreasing 3.2 and 1.9 fold, respectively.The results of the present study indicate that bradykinin elicits a transient increase of airway hyperresponsiveness in asthmatic subjects, but this was evident only using a sensitive indicator of the changes in airway reactivity, which suggests an effect at the level of the more peripheral airways. These data suggest that bradykinin may play a role in the pathogenesis of airway hyperresponsiveness in human asthma.