Abstract
Patients with Cystic Fibrosis (CF) have an increased incidence of bronchial hyper-reactivity to inhaled methacholine (MCh). There is also an increased skin reactivity to inhaled allergens and an increased incidence of allergic rhinitis. Thus, CF shares some clinical features with asthma and drugs used in asthma may be useful in CF.
Sodium cromoglycate (SCG) is efficacious in asthma, blocking some patients against MCh challenge and decreasing bronchial hyper-reactivity. We studied the potential role of SCG in CF by determining if it could block acute bronchoconstriction induced by MCh, and predict CF patients whose bronchial hyper-reactivity and symptoms would lessen with longterm use.
Fifteen CF patients known to respond to an MCh challenge were studied. None had clinical asthma, nor had intercurrent infections at the time of the study. Three standard MCh challenges were performed on consecutive days at the same time; two after placebo (distilled water) and one after 2ml 1% SCG, which were given in random order in a double-blind manner. As well as providing a baseline, the two placebo studies provided a measure of the reproducibility of the MCh challenges (variation less than 10%). There were only small changes in FEV1 after placebo and SCG (less than 6%). The mean FEV1 was 65% (range 32-90) and PD20 was calculated from the dose-response curves of cumulative MCh inhaled versus drop in FEV1. Four patients (27%) were completely protected by SCG. We conclude that longterm trials of SCG in CF are indicated to assess predictive ability of MCh challenge blocking for improved symptom scores and decreased MCh sensitivity. SCG may benefit selected CF patients.
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Newth, C., Eigen, H., Nickerson, B. et al. SODIUM CROMOGLYCATE INDUCED CHANGES lN THE DOSE-RESPONSE CURVE OF INHALED METHACHOLINE IN CYSTIC FIBROSIS. Pediatr Res 19, 1099 (1985). https://doi.org/10.1203/00006450-198510000-00182
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DOI: https://doi.org/10.1203/00006450-198510000-00182