Am. J. Respir. Crit. Care Med.,
Volume 159, Number 4, April 1999, 1228-1233
Different Effects of Inhaled Aspirinlike Drugs on
Allergen-Induced Early and Late Asthmatic Responses
PIERSANTE
SESTINI,
ROSA METELLA
REFINI,
MARIA GRAZIA
PIERONI,
ADRIANO
VAGHI,
MARIA
ROBUSCHI,
and
SEBASTIANO
BIANCO
Institute of Respiratory Diseases, University of Siena; Division of Pneumology, Hospital of Garbagnate; and Institute of
Cardiovascular and Respiratory Diseases, Ospedale S. Raffaele, Milan, Italy
Little is known about the anti-asthmatic effects of powerful anti-inflammatory agents such as aspirin-like drugs. We compared the effects of two aspirin-like drugs with different pharmacologic activities,
sodium salicylate (SSA) and indomethacin, with the effect of lysine acetylsalicylate (LASA), inhaled 30 min before challenge, on the early and the late asthmatic response induced by a single dose of allergen causing a 25% decrease in FEV1 in a preliminary challenge. Inhaled SSA partially prevented both the early and late response, providing a protection with respect to placebo of 22 ± 6% in the early
phase and 23 ± 9% in the late phase of the response. These values were lower (but not significantly) than those of LASA (41 ± 9% and 39 ± 11%, respectively). In a second group of patients, indomethacin failed to affect the early response, while LASA provided a protection of 31 ± 7%. However, these
two drugs were equally effective in reducing the late response (44 ± 18% and 39 ± 17% protection
for LASA and indomethacin, respectively). In subjects with an early response, despite being ineffective in preventing allergen-induced bronchoconstriction, indomethacin blocked the allergen-induced
increase in bronchial hyperresponsiveness measured 2 h after challenge. We conclude that inhaled
salicylates, but not indomethacin, exert a protective activity against the early allergic response. This
difference is not explained by the different pattern of cyclooxygenase inhibitory activity of these drugs.
