Airway responsiveness in wheezy infants: evidence for functional beta adrenergic receptors.

A Prendiville, S Green, M Silverman

Department of Paediatrics and Neonatal Medicine, Royal Postgraduate Medical School, Hammersmith Hospital, London.

The effect of nebulised salbutamol on the bronchial response to nebulised histamine was studied in five wheezy infants aged 3-12 months. The response to doubling concentrations of up to 8 g/l of histamine was assessed by the change in the maximum flow at FRC (VmaxFRC), measured by flow-volume curves produced during forced expiration with a pressure jacket. The concentration of histamine required to provoke a 30% fall in VmaxFRC (PC30) was measured. All of the infants responded to low concentrations of histamine during control tests before and after nebulised saline (mean PC30 1.07 and 0.51 g/l). On a separate day there was a similar response to histamine before salbutamol (PC30 0.57 g/l), but after salbutamol the response was completely abolished up to the maximum concentration of histamine in all subjects (PC30 greater than 8 g/l). Thus wheezy infants have highly effective beta 2 adrenoceptors in intrathoracic airways.

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