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Role of Autonomic Nervous System and the Cough Reflex in the Increased Responsiveness of Airways in Patients with Obstructive Airway Disease*

B. G. Simonsson, F. M. Jacobs§ and J. A. Nadelǁ

Cardiovascular Research Institute and the Department of Medicine, University of California San Francisco Medical Center, San Francisco, California

International Postdoctoral Research Fellow of the U. S. Public Health Service (FO5TW-893).

§ U. S. Public Health Service Fellowship HE-24,549.

ǁ Address requests for reprints to Dr. J. A. Nadel, Cardiovascular Research Institute, University of California San Francisco Medical Center, San Francisco, Calif. 94122.

* Received for publication 19 May 1967 and in revised form 12 July 1967.

Published November 1967

Inhalation of aerosols of citric acid, histamine phosphate, or carbon dust, or air cooled to - 20°C or rapid respiratory maneuvers (inspiration or expiration) results in an increase in airway resistance in some patients with asthma or bronchitis. It has been shown previously in animals that stimulation of cough receptors results in bronchoconstriction through efferent cholinergic pathways. In the patients studied, the administration of atropine sulfate, which would block such pathways, abolished the bronchoconstrictor effects of all the stimuli except large doses of histamine, which may exert a direct effect on airway smooth muscle. These data suggest that sensitized cough receptors may be involved in triggering reflex airway constriction in such patients.

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