Re: New asthma investigations

Dear John,

I send you the abstract of the russian scientist paper devoted to the asthma problem. 
He found that interaction of inhaled bronchodilators with own asthmatics' epinephrine 
may cause a lot of problem and in particulary sudden death. 
I hope that have sent what you was looking for the last year. The complete text of this 
investigation you can find at http://astma.angelcities.com/

Sincerely yours, Prof. Smith


EVOLUTION IN ASTHMA — 
EVOLUTION OF BRONCHIAL RESPONSE TO EPINEPHRINE

Dr. Victor N. Solopov
«Asthma Service», Medical Services Ltd., Moscow

KEY WORDS
Asthma evolution. Fenoterol. Epinephrine. Sudden death from asthma

ABSTRACT
The different types of bronchial response to fenoterol (Fen) and epinephrine (Epi) resulted 
after their consecutive inhalation and interaction in patients' airways depending on the 
evolution in asthma were studied in 396 subjects. 278 females and 118 males aged 16-69 
years were examined. The examination program consisted of the pulmonary function (PF) 
investigation, pharmacological testing using Fen, Epi, as well as evaluation of the illness 
duration (Till) and the reversibility of bronchial obstruction (RBO). The PF investigation 
and pharmacological testing were carried out according to the following scheme:
1)initial evaluation of the PF;  2)inhalation of 0.4 mg of Fen; 3)repeated evaluation 
of the PF 20 min later; 4)2 min inhalation of 0.1% solution of epinephrine hydrochloride 
by means of ultrasonic nebulizer with productivity 0.5 ml/min; 5)repeated evaluation 
of the PF 10 min later. RBO index was calculated as follows:
RBO=FEV1ini+ResFEV1fen+ResFEV1epi, where: 
FEV1ini=initial forced expiratory volume per the 1st sec;
ResFEV1fen=response to Fen; ResFEV1epi = response to Epi.
Till was determined as a length of the period from the appearance of the first asthmatic 
symptoms: persistent cough, dyspnea, wheezing and breathlessness up to moment 
of the patient's investigation and was confirmed more precisely by the clinical records data.
It was found that interaction of Fen and Epi seems to be a naturally determined process 
manifesting by the appearance of consecutive «waves» of epi-induced bronchodilation 
and bronchoconstriction. Epi-induced bronchoconstriction against the background 
fenoterol inhalation appears in spite of a long term steroid treatment. The severity 
of alpha-induced bronchoconstriction depends on the evolution in asthma and it seems 
to be one of the causes of asthmatics sudden death.

Received on Saturday, 19 October 2002 17:45:59 UTC