Blockade of airway sensory nerves and dyspnea in humans

Nausherwan K. Burki, Lu Yuan Lee

Research output: Contribution to journalArticlepeer-review

25 Scopus citations

Abstract

Evidence has accumulated from previous studies that vagal fibers in the lungs are involved in the genesis of dyspnea. In a series of human studies, based on our previous animal data (J Physiol 1998; 508:109-18; J Appl Physiol 1998; 84:417-24; J Appl Physiol 2003; 95:1315-24) we established that intravenous adenosine has a dyspnogenic effect (J Appl Physiol 2005; 98:180-5; Respir Res 2006; 7:139; Pulm Pharmacol Ther 2008; 21:208-13), strongly implicating a role for vagal C-fibers in the genesis of dyspnea. We have now analyzed the relative effects of blockade of vagal C-fibers by two methods and routes of delivery: by inhibition of the sodium channel and interruption of action potential conduction in the nerve by inhaled local anesthetic (lidocaine), and by blockade by systemic theophylline, a known, nonselective adenosine receptor antagonist. Both techniques significantly (p < 0.05) attenuated the dyspneic response to intravenous adenosine. However, the attenuation was significantly (p < 0.05) greater with pretreatment with systemic theophylline (mean change in response, ΔAUC -44%) versus pretreatment with inhaled lidocaine (mean change in response, ΔAUC -11.8%). These differences in the results of airway sensory nerve blockade probably reflect different populations of C fiber receptors and may explain conflicting results of previous studies of dyspnea and airway anesthesia.

Original languageEnglish
Pages (from-to)279-282
Number of pages4
JournalPulmonary Pharmacology and Therapeutics
Volume23
Issue number4
DOIs
StatePublished - Aug 2010

Bibliographical note

Funding Information:
Supported by USPHS NIH grant HL-65486 . The data with lidocaine have been partially published previously (Pulm Pharmacol & Therap 2008; 21(1), 208–13).

Keywords

  • Adenosine
  • Dyspnea
  • Lidocaine
  • Theophylline
  • Vagal C fibers

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Biochemistry, medical
  • Pharmacology (medical)

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