© 2007 American Thoracic Society
Racemic = R Enantiomer: A Dual CitationFrom the Authors:We were delighted to see that Dr. Leff read our work to a level of detail that allowed him to comment on our writing, particularly regarding his past work with enantiomers (1). However, we will say, categorically, that we stand firmly behind exactly what we wrote about his work, why we wrote it, and how it was written. As we saw it, the question regarding his work was, did (R)-albuterol suppress eosinophil peroxidase (EPO) release from human eosinophils? The answer is "yes," as shown by the decreasing EPO output with increasing drug concentration, in his Figures 1 and 3 (1). This result was not different from (R,S)-albuterol, which we acknowledged within the text of the same paragraph (2). Thus, we conveyed those data in a fair and accurate manner to support our point. However, Dr. Leff pointed out that some have interpreted his results with (S)-albuterol to be opposite to (R)-albuterol. Although we did not make that point, inspection of the normalized control group secretion data in Figures 2 and 4 of his article (i.e., FMLP/CB alone [with no drug]) reveals a control SEM that appears to be ±16–20%, when the mean spanned zero by about ±2% (1). Thus, his figure legend statement, "Note that secretion caused by the S-enantiomer falls within the confidence limits for the response with FMLP/CB alone" (1), may simply reflect the exceedingly large control variance, rather than a true lack of (S)-enantiomer effect. Moreover, the METHODS portion of his article states: "Comparisons of eosinophil peroxidase release between several groups were made by repeated-measures ANOVA" (1), leaving the reader to wonder which ones, and why not all of them? In fact, it is apparent that (S)-albuterol quelled this huge variation (down to ±3–5% SEM) and forced EPO release in a direction opposite of (R)-albuterol (1), which might have been statistically significant had the results of (S)-albuterol been compared with (R)- and (R,S)-albuterol. Unfortunately, nowhere in his article are those specific comparisons mentioned, which is why we remain cautious with our interpretations of his data. In summary, we maintain that it is not misleading, within a Pro-position/debate article, to cite his affirmative results in a comprehensive list of statistically significant effects of (R)-albuterol, followed by the clarifying factual statements regarding its comparison with (R,S)-albuterol. Thus, we appreciate the opportunity to further clarify our authorial style and position within this debate, and to discuss Dr. Leff's (S)-albuterol data.
The University of Texas Medical Branch, Galveston, Texas FOOTNOTES Conflict of Interest Statement: B.T.A. has received consultancy fees ($7,000), advisory fees ($4,500), and speaking fees ($8,500) from Sepracor over the past 3 years. W.J.C. has received consultancy fees ($5,000) and speaking fees ($6,000) from Sepracor in the past 3 years, and $18,000 in remuneration from Genentech. REFERENCES
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