Chest
Volume 108, Issue 2, August 1995, Pages 401-406
Journal home page for Chest

Clinical Investigations; Articles; Nebs and Flows
Impaired Bronchodilator Response to Albuterol in Healthy Elderly Men and Women

https://doi.org/10.1378/chest.108.2.401Get rights and content

Background

Lymphocytes of normal elderly subjects and young asthmatics display dysfunctional β-adrenoceptors. If β-adrenoceptor dysfunction were found in senescent airways, it might help explain the pathogenesis of late onset asthma.

Methods

The bronchodilatory effects of albuterol after methacholine-provoked bronchoconstriction were compared in 17 healthy young (age 20 to 36 years) and 17 healthy elderly (age 60 to 76 years) volunteer subjects. Albuterol was inhaled via dosimeter (initially 7.8 μg, doubling every 7.5 min) with forced expiratory flow at 50% vital capacity (FEF50) measured prior to each dose. Albuterol sensitivity was expressed as the cumulative logarithm of the area under the FEF50 recovery curve (AUC); a greater AUC meant lower sensitivity. On another study day, spontaneous recovery from methacholine was assessed similarly.

Results

There was no intergroup difference in spontaneous recovery. Despite lower methacholine doses provoking similar (35%) FEF50 falls in elderly subjects, albuterol AUC was greater in elderly subjects (6,552%·min·μg) than young subjects (3,922%·min μg; p=0.03). Multiple regression showed that AUC and age were related (p=0.02).

Conclusion

Airway β2-adrenoceptor responsiveness is diminished in old age, suggesting that airway βadrenoceptor dysfunction may be implicated in late-onset asthma. (CHEST 1995; 108:401-06)

Section snippets

Subjects

Seventeen healthy young (age 20 to 36 years) and 17 elderly (age 60 to 76 years) nonasthmatic subjects were recruited from the community. Subjects had normal baseline lung function with no respiratory or atopic history. Exclusion criteria were the following: cognitive impairment; pregnancy; cardiac disease; thyroid disorder; present cigarette smoking or smoking history of >10 pack-years; respiratory infection, medication change, or antihistamine treatment within 6 weeks; past or present

Results

For simplicity of presentation, data given will refer to day 2 unless otherwise stated. Analyses revealed very similar results on days 2 and 3.

Discussion

The present study has validated a method for the assessment of bronchodilator sensitivity to albuterol in normal subjects without baseline bronchoconstriction. Reproducibility of the results was good and compares well with reproducibility of bronchoconstrictor challenge with methacholine using this protocol in both young and elderly subjects.19, 20, 21 The study showed an impaired bronchodilator response to a β2-adrenergic agonist in healthy elderly subjects following methacholine challenge.

References (37)

  • BramanSS et al.

    Asthma in the elderly: a comparison between patients with recently acquired and long-standing disease

    Am Rev Respir Dis

    (1991)
  • CooksonDU et al.

    A comparison of the effects of isoproterenol in the normal and asthmatic subject

    Am Rev Respir Dis

    (1963)
  • ParkerCW et al.

    Alterations in cyclic adenosine monophosphate metabolism in human bronchial asthma: I

    Leucocyte responsiveness to beta adrenergic agents. J Clin Invest

    (1973)
  • KarimanK et al.

    Decreased beta-adrenergic receptor binding in lymphocytes from patients with asthma

    Lung

    (1980)
  • GalantSP et al.

    Beta adrenergic receptors of polymorphonuclear particulates in bronchial asthma

    J Clin Invest

    (1980)
  • VestalRE et al.

    Reduced beta-adrenoceptor sensitivity in the elderly

    Clin Pharmacol Ther

    (1979)
  • DillonN et al.

    Age and beta adrenoceptormediated function

    Clin Pharmacol Ther

    (1980)
  • KrallJF et al.

    Age-related elevation of plasma catecholamine concentration and reduced responsiveness of lymphocyte adenylate cyclase

    J Clin Endocrinol Metab

    (1981)
  • Cited by (0)

    Supported in part by the Department of Veterans Affairs (Onice of Research and Development, Medical Research Service) a grant-in-aid from the American Heart Association of Idaho and a grant from Glaxo Inc. Dr. Connolly was supported by the British Geriatrics Society/Nuffield Foundation Travelling Fellowship Dr. Crowley was the recipient of a Faculty Development Award in Clinical Pharmacology from the Pharmaceutical Manufacturers Association Foundation.

    Currently at University of Manchester, England.

    View full text