Effect of Disodium Cromoglycate on Exercise-induced Asthma

Davies, S. E.

doi:10.1136/bmj.3.5618.593

Cited by 166 publications

(56 citation statements)

References 6 publications

(3 reference statements)

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“…The role of mast cell mediator release in EIA was suggested in 1968 when it was shown that the mast cell stabilizing drug sodium cromoglycate was effective in preventing EIA [61]. Anderson has suggested that stimulus for the mediator release from mast cells during exercise is provided by hypertonicity of airway lining fluid [29].…”

Section: Mediator Release Hypothesismentioning

confidence: 99%

Mechanisms of exercise‐induced asthma

Makker

Holgate

1994

Eur J Clin Investigation

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Section: Mediator Release Hypothesismentioning

confidence: 99%

Mechanisms of exercise‐induced asthma

Makker

Holgate

1994

Eur J Clin Investigation

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“…For example, disodium cromoglycate (DSCG), a drug which stabilizes mast cell membranes, is effective in blunting exercise-induced asthma [6,7]. Pretreatment with a number of H 1 receptor antagonists has been shown to attenuate EIB [8][9][10]; however, the degree of protection afforded by this class of drugs has been modest.…”

Section: Aamentioning

confidence: 99%

Evidence for mast cell activation during exercise-induced bronchoconstriction

O’Sullivan¹,

Roquet²,

Dahlén³

et al. 1998

Eur Respir J

125

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Exercise-induced bronchoconstriction (EIB) is thought to occur in 70-80% of asthmatics, most commonly amongst those with moderate-to-severe airway hyperresponsiveness [1]. It is characterized by transient airflow obstruction resulting in a Š15% decrease in forced expiratory volume in one second (FEV1) following 5-8 min of exercise. The fall in FEV1 reaches a maximum approximately 10 min after exercise and gradually normalizes over the next hour [2]. The precise pathophysiology of EIB remains unclear, although it is widely accepted that during exercise the upper airways are unable to adequately warm and humidify the increased volumes of inspired air. This results in airway cooling and increased airway fluid osmolality in the lower airways [3,4]. One hypothesis suggests that hyperosmolar triggering of mast cells and possibly other inflammatory cells results in the release of bronchoconstricting mediators, e.g. cysteinyl-leukotrienes (cys-LTs), histamine and prostaglandin (PG)D 2 [5].Previous indications for the participation of mast cell mediators in the pathogenesis of EIB are based on pharmacological data. For example, disodium cromoglycate (DSCG), a drug which stabilizes mast cell membranes, is effective in blunting exercise-induced asthma [6,7]. Pretreatment with a number of H 1 receptor antagonists has been shown to attenuate EIB [8][9][10]; however, the degree of protection afforded by this class of drugs has been modest. More recently, studies employing leukotriene receptor antagonists [11,12] and biosynthesis inhibitors [13] have implicated leukotrienes in the airway bronchoconstrictor response to exercise.The direct approach of measuring mast cell mediator release in response to exercise challenge has yielded ambiguous results. Some studies have reported an elevation in plasma and whole blood histamine concentrations following EIB [14,15], while other studies have failed to verify those findings [16,17]. Apart from the methodological problems encountered when sampling plasma histamine [18] and its short half-life in the circulation, approximately 1 min [19], it has been suggested that elevations in plasma histamine mainly reflect the basophilia which normally accompanies exercise [20]. Increases in the levels of tryptase and PGD 2 , both specific mast cell markers, have been detected in nasal lavage following nasal provocation with cold dry air [21], but not after exercise [22,23].The purpose of this study was to provide evidence to establish mast cell activation as a feature of EIB. To this end, a combination of mast cell markers, 9α,11β-PGF 2 Sullivan, A. Roquet, B. Dahlén, F. Larsen, A. Eklund, M. Kumlin, P.M. O'Byrne, S-E. Dahlén. ©ERS Journals 1998. ABSTRACT: Controversy remains about the causative mediators in the bronchoconstrictive response to exercise in asthma. This study examined whether mast cell activation is a feature of exercise-induced bronchoconstriction by measuring urinary metabolites of mast cell mediators. Evidence for mast cell activation during exercise-induced bronchoconstriction....

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“…Eur Respir J., 1996, 9, 1891-1895. Disodium cromoglycate (DSCG) has been used for treatment of asthma, and for preventing attacks of exercise-induced bronchospasm (EIB) [1][2][3]. It is administered as a powder or in aerosol form by use of different devices for inhalation [4][5][6][7].…”

Section: Change In Osmolarity Of Disodium Cromoglycate Solution and Pmentioning

confidence: 99%

Change in osmolarity of disodium cromoglycate solution and protection against exercise-induced bronchospasm in children with asthma

Kano¹,

Hirose²,

Nishima³

1996

Eur Respir J

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It has been suggested that osmolarity and/or nebulizer output may affect the protective effects of disodium cromoglycate (DSCG) in asthma. The aim of this study was to evaluate the influence of osmolarity of the DSCG solution on exercise-induced bronchospasm (EIB) in children with bronchial asthma. A jet nebulizer was used for DSCG inhalation in Study 1 and an ultrasonic nebulizer in Study 2. Thirteen asthmatic children (7 males and 6 females, aged 6-14 yrs) were enrolled in Study 1, and nine asthmatic children (5 males and 4 females, aged 9-13 yrs) in Study 2. After pretreatment with saline (control), hypotonic DSCG or isotonic DSCG, children underwent exercise challenge with a cycle ergometer. The percentage fall in forced expiratory volume in one second (FEV1) was measured at 5 and 15 min postexercise. The data were compared by analysis of variance (ANOVA). Both in Study 1 and Study 2, there were no significant differences in minute ventilation volume or maximum heart rate during exercise between the different treatment groups. Both hypotonic and isotonic DSCG significantly reduced the maximum percentage fall in FEV1. There were no significant differences in protective effects between hypotonic and isotonic DSCG in either study. We conclude that the efficacy of hypotonic and isotonic disodium cromoglycate solutions is similar for protection against exercise-induced bronchospasm. Hypotonic disodium cromoglycate seems to be clinically effective for prevention of exercise-induced bronchospasm and treatment of asthmatic children.

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Effect of Disodium Cromoglycate on Exercise-induced Asthma

Abstract: In eight patients with exercise-induced asthma, disodium cromoglycate was found to produce a definite inhibition of the post-exercise fall in forced expiratory volume in one second. This effect may be part of the cause for the subjective improvement experienced with this drug.

Cited by 166 publications

References 6 publications

Mechanisms of exercise‐induced asthma

Mechanisms of exercise‐induced asthma

Evidence for mast cell activation during exercise-induced bronchoconstriction

Change in osmolarity of disodium cromoglycate solution and protection against exercise-induced bronchospasm in children with asthma

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