The Anatomical and Biochemical Basis of Bronchial Obstruction in Asthma
Authors: ELLIOTT MIDDLETON
Journal: Annals of Internal Medicine (1965)

Review1 October 1965The Anatomical and Biochemical Basis of Bronchial Obstruction in AsthmaELLIOTT MIDDLETON JR., M.D.ELLIOTT MIDDLETON JR., M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-63-4-695 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptThe purpose of this review is to draw together some considerations involving the anatomy and physiology of the normal lung, the pathology of bronchial obstruction in asthma, and the biochemical events leading to it. In so doing it is hoped to focus attention on a variety of facets of the lung in asthma not usually considered together.Bronchial asthma is a chronic disease characterized by episodic bronchial obstruction and ventilatory insufficiency and is manifested clinically by wheezing respirations, dyspnea, cough, and mucoid sputum production. The essential pathological changes in the bronchi and bronchioles which cause these symptoms are mucosal edema,...References1. MAXIMOWBLOOM AAW: A Textbook of Histology. W. B. Saunders Co., Philadelphia, 1944. Google Scholar2. KRAHL VB: Microstructure of the lung. Arch. Environ. Health (Chicago) 6: 37, 1963. CrossrefMedlineGoogle Scholar3. CLEMENTS JA: Surface tension in the lungs. Sci. Amer. 207: 120, 1962. CrossrefMedlineGoogle Scholar4. RADFORD EP: Mechanical stability of the lung. Arch. Environ. Health (Chicago) 6: 128, 1963. CrossrefMedlineGoogle Scholar5. WIDDICOMBE JG: Regulation of tracheobronchial smooth muscle. Physiol. Rev. 43: 1, 1963. CrossrefMedlineGoogle Scholar6. GLYNNMICHAELS AAL: Bronchial biopsy in chronic bronchitis and asthma. Thorax 15: 142, 1960. CrossrefGoogle Scholar7. RILEY JF: The Mast Cells. Livingstone, Edinburgh, 1959. Google Scholar8. SALVATO G: Mast cells in bronchial connective tissue of man. Experientia 15: 308, 1959. CrossrefMedlineGoogle Scholar9. BROGAN TD: The carbohydrate complexes of bronchial secretion. Biochem. J. 71: 125, 1959. CrossrefMedlineGoogle Scholar10. GOODMANGILMAN LSA: The Pharmacological Basis of Therapeutics. The Macmillan Co., New York, 1955. Google Scholar11. HILDING AC: Phagocytosis, mucous flow, and ciliary action. Arch. Environ. Health (Chicago) 6: 61, 1963. CrossrefMedlineGoogle Scholar12. KORDIKBURNBULBRING PJHE: Ciliary movement and acetylcholine. Brit. J. Pharmacol. 7: 67, 1952. Google Scholar13. GOSSELIN RE: The cilioexcitatory activity of serotonin. J. Cell. Comp. Physiol. 58: 17, 1961. CrossrefMedlineGoogle Scholar14. MILLER WS: The Lung, 2nd ed. Charles C Thomas, Springfield, Ill., 1947. Google Scholar15. SEVERINGHAUSSTUPFEL JWM: Respiratory dead space increase following atropine in man, and atropine, vagal or ganglionic blockade and hypothermia in dogs. J. Appl. Physiol. 8: 81, 1955. CrossrefMedlineGoogle Scholar16. BUTLERCAROALCALADUBOIS JCGRAB: Physiological factors affecting airway resistance in normal subjects and in patients with obstructive respiratory disease. J. Clin. Invest. 39: 584, 1960. CrossrefMedlineGoogle Scholar17. TULOU P: Influence du calibre de la trachee et des grosses bronches sur la ventilation pulmonaire. Apport des méthodes d'valuation fonctionnelle et en particulier de la mesure de l'espace mort anatomique. Bronches 11: 55, 1961. Google Scholar18. WIDDICOMBEKENTNADEL JGDCJA: The mechanism of bronchoconstriction during inhalation of dust. J. Appl. Physiol. 17: 613, 1962. CrossrefMedlineGoogle Scholar19. DUBOISDAUTREBANDE ABL: Acute effects of breathing inert dust particles and of carbachol aerosol on the mechanical characteristics of the lungs in man. Changes in response after inhaling sympathomimetic aerosols. J. Clin. Invest. 37: 1746, 1958. CrossrefMedlineGoogle Scholar20. NADELCOMROE JAHJ: Acute effects of inhalation of cigarette smoke on airway conductance. J. Appl. Physiol. 16: 713, 1961. CrossrefMedlineGoogle Scholar21. KLASSENMORTONCURTIS KPDRGM: The clinical physiology of the human bronchi. III. The effect of vagus section on the cough reflex, bronchial caliber and clearance of bronchial secretions. Surgery 29: 483, 1951. MedlineGoogle Scholar22. WELLSWALKERHICKLER REJERB: Effects of cold air on respiratory air flow resistance in patients with respiratory-tract disease. New Eng. J. Med. 263: 268, 1960. CrossrefMedlineGoogle Scholar23. GORDONOFF T: Physiologie und Pharmakologie des Expektorations-Vorganges. Ergebn. Physiol. 40: 53, 1938 (cited in 24). CrossrefGoogle Scholar24. BUKANTZBERN SCAW: Studies with sputum. I. Initial observations on the chemical nature and blood group substance content of asthmatic sputum. J. Allerg. 29: 29, 1958. CrossrefGoogle Scholar25. TAPPANZALAR VV: The pathophysiology of bronchial mucus, in Mucous Secretions, pp. 722-745. Ann. NY Acad. Sci. 106: 157, 1963. Google Scholar26. MENDESSTRAUSSFERRIULHOA CINTRA EARGAB: Immunochemical studies of the asthmatic sputum. Acta Allerg. (Kobenhavn) 18: 17, 1963. CrossrefMedlineGoogle Scholar27. HUBERKOESSLER HLKK: The pathology of bronchial asthma. Arch. Intern. Med. (Chicago) 30: 689, 1922. CrossrefGoogle Scholar28. CARDELLBRUCE PEARSON BSRS: Death in asthmatics. Thorax 14: 341, 1959. CrossrefGoogle Scholar29. NAYLOR B: The sheeding of the mucosa of the bronchial tree in asthma. Thorax 17: 69, 1962. CrossrefMedlineGoogle Scholar30. CREPEAHARMAN SBJW: The pathology of bronchial asthma. I. The significance of membrane changes in asthmatics and non-allergic pulmonary disease. J. Allerg. 26: 453, 1955. CrossrefMedlineGoogle Scholar31. STANWORTH DR: Reaginic antibodies. Advances Immun. 3: 181, 1963. CrossrefGoogle Scholar32. LOVELESS MH: Immunological studies of pollinosis. II. Passive sensitization of man through transfusion. J. Immun. 41: 15, 1941. Google Scholar33. SHERMANSEEBOHM WBPM: Passive transfer of cold urticaria. J. Allerg. 21: 414, 1950. CrossrefMedlineGoogle Scholar34. SCHILDHAWKINSMONGARHERXHEIMER HODFJLH: Reactions of human asthmatic lung and bronchial tissue to a specific antigen. Lancet 2: 376, 1951. CrossrefMedlineGoogle Scholar35. KATZCOHEN GS: Experimental evidence for histamine release in allergy. JAMA 117: 1782, 1941. CrossrefGoogle Scholar36. MIDDLETONSHERMAN EWB: Relationship of complement to allergic histamine release in blood of ragweed-sensitive subjects. J. Allerg. 31: 441, 1960. CrossrefGoogle Scholar37. LICHTENSTEINOSLER LMAG: Studies on the mechanisms of hypersensitivity phenomena. IX. Histamine release from human leukocytes by ragweed pollen antigen. J. Exp. Med. 120: 507, 1964. CrossrefMedlineGoogle Scholar38. HEREMANSVAERMAN JFJP: Beta2 A-globulin as a possible carrier of allergic reaginic activity. Nature 193: 1091, 1962. CrossrefMedlineGoogle Scholar39. FIREMANVANNIERGOODMAN PWEHC: The association of skin-sensitizing antibody with B2 A-globulins in sera from ragweed-sensitive patients. J. Exp. Med. 117: 603, 1963. CrossrefMedlineGoogle Scholar40. ISHIZAKAISHIZAKAHORNBROOK KTM: Blocking sensitization with reagin by B2 A-globulin. J. Allerg. 34: 395, 1963. CrossrefMedlineGoogle Scholar41. SHERMANHAMPTONCOOKE WBSFRA: The placental transmission of antibodies in the skin sensitive type of human allergy. J. Exp. Med. 72: 611, 1940. CrossrefMedlineGoogle Scholar42. ALLANSMITHBUELL WDN: The relationship of gamma-1A globulin and reagin in cord sera. J. Allerg. 35: 339, 1964. CrossrefMedlineGoogle Scholar43. ROCKEYKUNKEL JHHG: Unusual sedimentation and sulfhydryl sensitivity of certain isohemagglutinins and skin-sensitizing antibody. Proc. Soc. Exp. Biol. Med. 110: 101, 1962. CrossrefMedlineGoogle Scholar44. LOVELESS MH: Reagin production in a healthy male who forms no detectable B2 A immunoglobulins. Fed. Proc. 23: 403, 1964. Google Scholar45. MONGARSCHILD JLHO: Cellular mechanisms in anaphylaxis. Physiol. Rev. 42: 226, 1962. CrossrefMedlineGoogle Scholar46. UNGARHAYASHI GH: Enzymatic mechanisms in allergy. Ann. Allerg. 16: 542, 1958. MedlineGoogle Scholar47. SALVATO G: Asthma and mast cells of bronchial connective tissue. Experienta 18: 330, 1962. CrossrefMedlineGoogle Scholar48. STONEMERRILLMENEELY JLJMGR: Distribution of histamine in human tissues. Fed. Proc. 14: 147, 1955. Google Scholar49. GRAHAMHANNEGANNOURSE HTTWCM: Dependence of tissue histamine content on local histidine decarboxylase activity. Biochim. Biophys. Acta 20: 243, 1956. CrossrefMedlineGoogle Scholar50. SCHAYER RW: Further evidence that pyridoxal phosphate in the coenzyme of mammalian histidine decarboxylase. Fed. Proc. 18: 317, 1959. Google Scholar51. GRAHAMLOWRYWAHLPRIEBAT HTOHNMK: Mast cells as sources of tissue histamine. J. Exp. Med. 102: 307, 1955. CrossrefMedlineGoogle Scholar52. SANYALWEST RKGB: Binding of histamine in mammalian tissues. Nature 178: 1293, 1956. CrossrefMedlineGoogle Scholar53. LINDAHL KM: The binding of histamine to phosphatides. Acta Physiol. Scand. 35: 146, 1955. CrossrefMedlineGoogle Scholar54. GREENROBINSONDAY JPJDM: Interaction between cerebroside sulfate and amines. J. Pharmacol. Exp. Ther. 131: 12, 1961. MedlineGoogle Scholar55. MIDDLETONPHILLIPS EGB: Distribution and properties of anaphylactic and venom—induced slow-reacting-substance and histamine in guinea pigs. J. Immun. 93: 220, 1964. MedlineGoogle Scholar56. BROCKLEHURST WE: A slow reacting substance in anaphylaxis, in Histamine, Ciba Foundation Symposium. Little, Brown and Co., Boston, 1956, pp. 175-179. Google Scholar57. HUMPHREY JH: Biochemical mediators of antigen-antibody reactions, in Proceedings of the Fourth International Congress of Allergology. Pergamon Press, New York, 1962, pp. 71-83. Google Scholar58. AUSTENHUMPHREY KJH: In vitro studies of the mechanism of anaphylaxis. Advances Immun. 3: 1, 1963. CrossrefGoogle Scholar59. AUSTENBROCKLEHURST KFWE: Anaphylaxis in chopped guinea pig lung. I. Effect of peptidase substrates and inhibitors. J. Exp. Med. 113: 521, 1961. CrossrefMedlineGoogle Scholar60. MIDDLETON E: In vitro passive transfer of atopic hypersensitivity. Proc. Soc. Exp. Biol. Med. 104: 245, 1960. CrossrefGoogle Scholar61. VAN ARSDELSELLS PPCJ: Antigenic histamine release from passively sensitized human leukocytes. Science 41: 1190, 1963. CrossrefGoogle Scholar62. SPAINSTRAUSSNEUMAN WCMBE: In vitro release of histamine by hypersensitive (allergic) serum in contrast to immune (treated) allergic serum in antigen and normal rabbit blood mixtures. J. Allerg. 21: 318, 1950. CrossrefMedlineGoogle Scholar63. NOAHBRAND JWA: Release of histamine in the blood of ragweed-sensitive individuals. J. Allerg. 25: 210, 1954. CrossrefMedlineGoogle Scholar64. VAN ARSDELMIDDLETONSHERMANBUCHWALD PPEWBH: A quantitative study on the in vitro release of histamine from leukocytes of atopic persons. J. Allerg. 29: 429, 1958. CrossrefMedlineGoogle Scholar65. WEISSROBBBLUMGART SGPHL: The velocity of blood flow in health and disease as measured by the effect of histamine on the minute vessels. Amer. Heart J. 4: 664, 1929. CrossrefGoogle Scholar66. CURRYLOWELL JJFC: Measurement of vital capacity in asthmatic subjects receiving histamine and acetyl-beta-methyl choline. J. Allerg. 19: 9, 1948. CrossrefMedlineGoogle Scholar67. BEALL GN: Plasma histamine concentrations in allergic diseases. J. Allerg. 34: 8, 1963. CrossrefMedlineGoogle Scholar68. BOUHUYSJONSSONLICHTNECKERTLINDELLLUNDGRENLUNDINRINGQUIST ARSSCGTR: Effects of histamine on pulmonary ventilation in man. Clin. Sci. 19: 79, 1960. MedlineGoogle Scholar69. HELANDERLINDELLSODERHOLMWESTLING ESBH: Observations on the pulmonary circulation during induced bronchial asthma. Acta Allerg. (Kobenhavn) 17: 112, 1962. CrossrefMedlineGoogle Scholar70. ARBORELIUSEKWALLJERNERUSLUNDINSVANBERG MBRGL: Unilateral provoked bronchial asthma in man. J. Clin. Invest. 41: 1236, 1962. CrossrefMedlineGoogle Scholar71. SCHAYER RW: Catabolism of physiological quantities of histamine in vivo. Physiol. Rev. 39: 116, 1959. CrossrefMedlineGoogle Scholar72. BEALLVAN ARSDEL GNPP: Histamine metabolism in human disease. J. Clin. Invest. 39: 676, 1960. CrossrefMedlineGoogle Scholar73. ARNOLDSSONHELANDERHELANDERLINDELLLINDHOLMOLSSONROOSSVANBORGSODERHOLMWESTLING HCESBOBABH: Elimination of C14-histamine from the blood in man. Scand. J. Clin. Lab. Invest. 14: 241, 1962. CrossrefMedlineGoogle Scholar74. HELANDERLINDELLNILSSONWESTLING ESKH: Catabolism of C14-labelled histamine in patients with allergic diseases. Acta Allerg. (Kobenhavn) 17: 86, 1962. CrossrefMedlineGoogle Scholar75. FELDBERGKELLAWAY WCH: Liberation of histamine and formation of a lysolecithin-like substance by cobra venom. J. Physiol. 94: 187, 1938. CrossrefMedlineGoogle Scholar76. KELLAWAYTRETHEWIE CHER: The liberation of a slow-reacting smooth-muscle stimulating substance in anaphylaxis. Quart. J. Exp. Physiol. 30: 121, 1940. CrossrefGoogle Scholar77. BROCKLEHURST WE: Occurrence of an unidentified substance durnig anaphylactic shock in cavy lung. J. Physiol. 120: 16P, 1953. MedlineGoogle Scholar78. BROCKLEHURST WE: Histamine and other mediators in hypersensitivity reactions, in Proceedings of the Third International Congress of Allergology. Flammarion, Paris, 1958, pp. 361-376. Google Scholar79. BROCKLEHURST WE: The release of histamine and formation of a slow-reacting substance (SRS-A) during anaphylactic shock. J. Physiol. 151: 416, 1960. CrossrefMedlineGoogle Scholar80. HARKAVY J: Spasm-producing substance in the sputum of patients with bronchial asthma. Arch. Intern. Med. (Chicago) 45: 641, 1930. CrossrefGoogle Scholar81. BROCKLEHURST WE: Slow reacting substance and related compounds. Progr. in Allerg. 6: 539, 1962. MedlineGoogle Scholar82. CHAKRAVARTY N: The occurrence of a lipid-soluble smooth-muscle stimulating principle ("SRS") in anaphylactic reaction. Acta Physiol. Scand. 48: 167, 1960. CrossrefMedlineGoogle Scholar83. VOGT W: Pharmacologically active substances formed in egg yolk by cobra venom. J. Physiol. 136: 131, 1957. CrossrefMedlineGoogle Scholar84. MURAOKAINOUEYAMASAKI SMH: Enzymatic formation of histamine ribotide from histamine dinucleotide. Nature 190: 532, 1961. CrossrefMedlineGoogle Scholar85. SMITH WG: The slow reacting substance of anaphylaxis: its identification as a mixture of glycosides of neuraminic acid. Life Sci. 4: 133, 1962. CrossrefGoogle Scholar86. GOADBYSMITH PWG: The effects of hydrocortisone by the changes in lipid metabolism induced in guinea pig lung tissue by anaphylaxis in vivo. J. Pharm. Pharmacol. 14: 739, 1962. CrossrefMedlineGoogle Scholar87. SMITH WG: The effect of ethanolamine on changes in lung lipids induced by anaphylaxis. Biochem. Pharmacol. 11: 183, 1962. CrossrefMedlineGoogle Scholar88. SMITH WG: The anti-anaphylactic activity of ethanolamine and choline. J. Pharm. Pharmacol. 13: 1, 1961. CrossrefGoogle Scholar89. BERRYCOLLIERHOLGATE PAHOJA: Bronchoconstrictor action in vivo of slow-reacting substance in anaphylaxis (SRS-A) and its antagonism. J. Physiol. 165: 41P, 1962. Google Scholar90. HERXHEIMERSTRESEMAN HE: The effect of slow reacting substance (SRS-A) in guinea pigs and in asthmatic patients. J. Physiol. 165: 78P, 1963. Google Scholar91. TRETHEWIE ER: Antiallergic effect of cortisone. Nature 181: 625, 1958. CrossrefGoogle Scholar92. TRETHEWIE ER: Cortisone and anaphylaxis. Aust. J. Exp. Biol. Med. Sci. 36: 275, 1958. CrossrefMedlineGoogle Scholar93. TRETHEWIE ER: Testosterone and asthma. Nature 198: 290, 1963. CrossrefMedlineGoogle Scholar94. VAREKAMPVOORHORST HR: Age and sex in atopic and non-atopic asthma. Acta Allerg. (Kobenhavn) 18: 69, 1963. CrossrefMedlineGoogle Scholar95. BROCKLEHURST WE: Unpublished observations cited in 81. Google Scholar96. KIMURAYOUNGRICHARDS ETPRRK: Pharmacologic properties of N-p-chlorobenzhydryl-N1-methyl homopiperazine dihydrochloride (homochlorcyclizine; SA-97), a serotonin antagonist. J. Allerg. 31: 237, 1960. CrossrefMedlineGoogle Scholar97. HUMPHREY JH: Biochemical aspects of reactions in hypersensitive responses, in Cellular and Humorial Aspects of the Hypersensitive States. LAWRENCE, H. S., ed., Paul B. Hober, Inc., New York, 1959, pp. 1-42. Google Scholar98. ELLIOTTLEWISHORTON DFGPEW: The structure of bradykinin-A plasma from ox blood. Biochem. Biophys. Res. Commun. 3: 87, 1960. CrossrefGoogle Scholar99. SCHACHTER M, (ed.): Polypeptides Which Affect Smooth Muscle and Blood Vessels. Pergamon Press, New York, 1960. Google Scholar100. WEBSTERPIERCE MEJV: Action of the kallikreints on synthetic ester substrates. Proc. Soc. Exp. Biol. Med. 107: 186, 1961. CrossrefMedlineGoogle Scholar101. LEWIS GP: Active polypeptides derived from plasma proteins. Physiol. Rev. 40: 647, 1960. CrossrefMedlineGoogle Scholar102. BERALDO WT: Formation of bradykinin in anaphylactic and peptone shock. Amer. J. Physiol. 163: 283, 1950. CrossrefMedlineGoogle Scholar103. BROCKLEHURSTLAHIRI WESC: The production of bradykinin in anaphylaxis. J. Physiol. 160: 15P, 1961. Google Scholar104. BROCKLEHURSTLAHIRI WESC: Formation and destruction of bradykinin during anaphylaxis. J. Physiol. 165: 39P, 1962. Google Scholar105. LOWELLFRANKLINSCHILLERFOLLENSBY FCWIWEM: Acute allergic reactions induced in subjects with hay fever and asthma by the intravenous administration of allergens with observations on blood clot lysis. J. Allerg. 27: 369, 1956. CrossrefMedlineGoogle Scholar106. BHOOLACOLLIERSCHACHTERSHORLEY KDHOMPG: Action of some peptides on bronchial muscle. Brit. J. Pharmacol. Chemother. 19: 190, 1962. CrossrefMedlineGoogle Scholar107. MÉLONLECOMTE JJ: Etude comparée des effets de la bradykinine et des reactions anaphylactiques locales chez l'homme. Int. Arch. Allerg. 21: 89, 1962. CrossrefGoogle Scholar108. LECOMTEPETITMÉLONTROQUETMARCELLE JJMJJR: Propriétés broncho-constrictrices de la bradykinine chez l'homme asthmatique. Arch. Int. Pharmacodyn. 137: 232, 1962. Google Scholar109. ERDOSSLOANE EGEM: An enzyme in human blood plasma that inactivates bradykinin and kallidins. Biochem. Pharmacol. 11: 585, 1962. CrossrefMedlineGoogle Scholar110. COLLIERSHORELEY HOPG: Analgesic antipyretic drugs as antagonists of bradykinin. Brit. J. Pharmacol. 15: 601, 1960. Google Scholar111. EPPINGERHESS HL: Zur Pathologie des Vegetatives Nervensystem. Z. Klin. Med. 67: 345, 1909. Google Scholar112. AHLQUIST RP: A study of the adrenotropic receptors. Amer. J. Physiol. 153: 586, 1948. CrossrefMedlineGoogle Scholar113. FISHELSZENTIVANYITALMAGE CWADW: Sensitization and desensitization of mice to histamine and serotonin by neurohumors. J. Immun. 89: 8, 1962. MedlineGoogle Scholar114. COOKSONREED DUCB: A comparison of the effects of isoproterenol in the normal and asthmatic subject. Amer. Rev. Resp. Dis. 88: 636, 1963. MedlineGoogle Scholar115. SCUDAMOREVORHAUSKARK HHHJRM: Acetylcholine and cholinesterase in the blood of patients suffering with bronchial asthma. J. Lab. Clin. Med. 37: 860, 1951. MedlineGoogle Scholar116. MICHELSONLOWELL ALFC: Blood acetylcholine in bronchial asthma. J. Lab. Clin. Med. 47: 119, 1956. MedlineGoogle Scholar117. NAKAMURA K: Allergy and Anaphylaxis. Department of Bacteriology, Nippon Medical School, Tokyo, Japan, 1954. Google Scholar118. TIFFENEAU R: Hiperexcitabilidad del aparato broncomotor del asmatico. Excitaciones broncoconstrictivas asmogenas. Rev. Argent. Alerg. 8: 33, 1961. MedlineGoogle Scholar119. SAMTERBERRYMAN MGH: The Mechanism of Drug Reaction. Proceedings of the Third International Congress of Allergology, Flammarion, Paris, 1958, pp. 261-268. Google Scholar120. PATON WD: The mechanism of histamine release, in Histamine, Ciba Foundation Symposium. Little, Brown and Co., Boston, 1956, pp. 59-78. CrossrefGoogle Scholar121. KARCZEWSKI W: The electrical activity of the vagus nerve in anaphylactic shock. Acta Allerg. (Kobenhavn) 17: 334, 1962. CrossrefMedlineGoogle Scholar122. ERSPAMER V: Pharmacology of indolealkylamines. Pharmacol. Rev. 6: 425, 1954. MedlineGoogle Scholar123. PAGE IH: Serotonin (5-hydroxytryptamine). Physiol Rev. 34: 563, 1954. CrossrefMedlineGoogle Scholar124. PAGE IH: Serotonin (5-hydroxytryptamine). Last four years. Physiol. Rev. 38: 277, 1958. CrossrefMedlineGoogle Scholar125. LEWIS GP (ed.): 5-Hydroxytryptamine, Proceedings of a symposium held in London April 1-2, 1957. Pergamon Press, New York, 1958. Google Scholar126. SJOERDSMA A: Serotonin. New Eng. J. Med. 261: 181, 231, 1959. CrossrefMedlineGoogle Scholar127. UDENFRIENDWAALKES STP: On the Role of Serotonin in Anaphylaxis in Mechanisms of Hypersensitivity. Little, Brown and Co., Boston, 1959, pp. 219-226. Google Scholar128. PARRATTWEST JRGB: 5-hydroxytryptamine and tissue mast cells. J. Physiol. 137: 169, 1957. CrossrefMedlineGoogle Scholar129. SJOERDSMAWEISSBACHUDENFRIEND AHSA: Clinical, physiologic and biochemical study of patients with malignant carcinoid (argentiffinoma). Amer. J. Med. 20: 520, 1956. CrossrefMedlineGoogle Scholar130. MUSTALAAIRAKSINEN OOMM: Excretion of histamine and metabolites of 5-hydroxytryptamine in a case of metastasized carcinoid tumour. Acta Med. Scand. 171: 483, 1962. CrossrefMedlineGoogle Scholar131. MICHELSONHOLLANDERLOWELL ACWFC: Effect of 5-hydroxytryptamine (serotonin) on respiration of non-asthmatic and asthmatic subjects. J. Lab. Clin. Med. 51: 57, 1958. MedlineGoogle Scholar132. WAALKESWEISSBACHBOIZCEVICHUDENFRIEND TPHJS: Serotonin and histamine release during anaphylaxis in the rabbit. J. Clin. Invest. 36: 1115, 1957. CrossrefMedlineGoogle Scholar133. WAALKESWEISSBACHBOIZCEVICHUDENFRIEND TPHJS: Further studies on release of serotonin and histamine during anaphylaxis in the rabbit. Proc. Soc. Exp. Biol. Med. 95: 479, 1957. CrossrefMedlineGoogle Scholar134. WAALKESCOBURN TPH: The role of platelets and the release of serotonin and histamine during anaphylaxis in the rabbit. J. Allerg. 30: 394, 1959. CrossrefGoogle Scholar135. STORCKHOIGNEKOLLER HRF: Thrombocytes in allergic reactions. Int. Arch. Allerg. 6: 372, 1955. CrossrefGoogle Scholar136. BERGWESTERMEYER RLC: Serotonin metabolites in bronchial asthma (abstract). Presented at the Fourteenth Annual Meeting, American Academy of Allergy, Philadelphia, 1958. Google Scholar137. FEINGOLD BF: Infection in bronchial allergic disease: bronchial asthma, allergic bronchitis, asthmatic bronchitis. Pediat. Clin. N. Amer. 6: 709, 1959. CrossrefGoogle Scholar138. FALLIERSHALBERSTEINBUKANTZ CJSGSC: Effect of rubeola, rubella, varicella, and a viral upper respiratory infection upon the severity of childhood asthma: with a note on the role of corticosteroids. J. Allerg. 32: 69, 1961. CrossrefMedlineGoogle Scholar139. STEVENSJORDANI FAW: Delayed and immediate reactions to bacterial nucleoproteins in asthma, hay fever and a group of miscellaneous diseases. J. Immun. 31: 477, 1936. Google Scholar140. RAPPAPORTSAMTERCATCHPOLESCHILLER BZMHRF: The mucoproteins of the nasal mucosa of allergic patients before and after treatment with corticotropin. J. Allerg. 24: 35, 1953. CrossrefGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: ELLIOTT MIDDLETONJR., M.D.Affiliations: New York, New YorkFrom the College of Physicians and Surgeons, Columbia University, New York, N. Y.Requests for reprints should be addressed to Elliott Middleton, Jr., M.D., 4 Duryea Rd., Upper Montclair, N. J. 07043. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byATOPIC ALLERGY AND IMMUNOGLOBULINS IN CHILDREN WITH ADENOIDS AND RECURRENT OTITIS MEDIAHyperglycemic Response to Epinephrine in Asthmatic Children Part I: Hyperglycemic Response to Epinephrine in Asthmatic Children with Varying Severity and at AttacksHyperglycemic Response to Epinephrine in Asthmatic Children Part II: Seasonal Change of Hyperglycemic Response to Epinephrin in Asthmatic ChildrenDEATHS IN PRIMARY ASTHMA WITH SPECIAL REFERENCE TO PATHOLOGYA Behavioral Treatment of Bronchial Asthma in Modified Group TherapyEarly ventilation-perfusion changes in asthmaThe Asthmatic Patient as a Surgical RiskThe significance of regional pulmonary function changes in bronchial asthmaAllergic asthma in childhood.Prospects in Asthma Therapy: Disodium Cromoglycate and DiethylcarbamazineMetabolic response to epinephrine in bronchial asthmaStudies on “intrinsic” allergic respiratory disease, with a hypothesis concerning its pathogenesisManagement of the Child with Bronchial Asthma: Pathologic, Physiologic and Pharmacologic ProblemsCurrent Concepts in the Management of the Patient with Status AsthmaticusIatrogenic Asthma Associated with Adrenergic AerosolsJOHN F. KEIGHLEY, M.B.Bronchoperviant Effects of Pimetine 1 October 1965Volume 63, Issue 4Page: 695-714KeywordsAnatomical pathologyAsthmaBronchiBronchiolesDyspneaEdemaLungsRespirationSputumSurgeons ePublished: 1 December 2008 Issue Published: 1 October 1965 PDF downloadLoading ...