Bronchodilator Agents ; therapeutic use ; China ; epidemiology ; Humans ; Phosphodiesterase Inhibitors ; therapeutic use ; Pulmonary Disease, Chronic Obstructive ; drug therapy ; epidemiology ; etiology ; pathology ; Theophylline ; therapeutic use

BACKGROUND: Sinus node dysfunction (SND) is caused not only by intrinsic sinus node disease, but also by the extrinsic factors. Among the extrinsic factors, autonomic imbalance is most common. Symptomatic SND usually requires permanent pacemaker therapy. However, the clinical characteristics and patient response to medical therapy for hypervagotonic SND have not been properly clarified. MATERIALS AND METHODS: Thirty two patients (14 men, 18 women, 51 +/- 14 years) with hypervagotonic SND were included in this study, but those patients who had taken calcium antagonists, beta-blockers or other antiarrhythmic drugs were excluded. Hypervagotonic SND was diagnosed if the abnormal electrophysiologic properties of the sinus node were normalized after the administration of atropine (0.04 mg/kg). RESULTS: The presenting arrhythmias were 16 cases of sinus bradycardia (50.0%), 12 of sinus pause (37.5%), 3 of sinoatrial block (9.4%) and 1 of tachy-bradycardia (3.1%). Nine (28.1%) patients had hypertension, 7 (21.9%) smoked, 2 (6.3%) had diabetes mellitus, and 1 (3.1%) had hypercholesterolemia. Among the patients, 3 had no remarkable symptoms, 13 had dizziness, 7 had syncope, 3 had weakness and 6 had shortness of breath. Twenty five (78.1%) patients were treated with theophylline, 1 patient with tachy-bradycardia syndrome was treated with digoxin and propafenone, and 6 (18.8%) were treated with no medication. During the 43 +/- 28 month follow-up, 25 patients remained asymptomatic, but 6 who took no medication developed mild dizziness. One patient needed permanent pacemaker implantation owing to recurrent syncope despite of theophylline treatment. CONCLUSION: These results show that hypervagotonic SND has a benign course and most of the patients can be managed safely without implanting a pacemaker. (Ed note: I like the abstract. It is short and direct, as it should be.)
Dizziness/etiology ; Dyspnea/etiology ; Female ; Humans ; Male ; Middle Aged ; Muscle Weakness/etiology ; Sick Sinus Syndrome/*complications/drug therapy ; Syncope/etiology ; Theophylline/therapeutic use ; Vasodilator Agents/therapeutic use

Adrenal Cortex Hormones ; therapeutic use ; Apoptosis ; drug effects ; Drug Resistance ; Humans ; Neutrophils ; cytology ; drug effects ; Pulmonary Disease, Chronic Obstructive ; drug therapy ; Theophylline ; therapeutic use

Theophylline has been reduced usage in asthma and chronic obstructive pulmonary disease because of the high frequency of side effects and the relatively low efficacy. However, recent researches have demonstrated that low-dose theophylline can not only relax airway smooth muscle but also have anti-inflammatory or immunomodulatory actions, which provides theory basis for the treatment of asthma and chronic obstructive pulmonary disease.
Asthma ; drug therapy ; Bronchodilator Agents ; adverse effects ; therapeutic use ; Humans ; Pulmonary Disease, Chronic Obstructive ; drug therapy ; Theophylline ; adverse effects ; therapeutic use

Theophylline is commonly used to treat severe asthma and chronic obstructive pulmonary disease (COPD) characterized by non-eosinophilic inflammation. Acetyl salicylic acid (ASA) is one of the most widely used medications worldwide, but up to 20% of patients with asthma experience aggravated respiratory symptoms after taking ASA. Here we evaluated the adverse effect of ASA on the therapeutic effect of theophylline in mice with non-eosinophilic asthma. A non-eosinophilic asthma mouse model was induced by airway sensitization with lipopolysaccharide-containing allergen and then challenged with allergen alone. Therapeutic intervention was performed during allergen challenge. Theophylline inhibited lung inflammation partly induced by Th1 immune response. ASA attenuated the beneficial effects of theophylline. However, co-administration of the ASA metabolite salicylic acid (SA) showed no attenuating effect on theophylline treatment. The therapeutic effect of theophylline was associated with increase in cAMP levels, which was blocked by co-treatment of theophylline and ASA. ASA co-treatment also attenuated the anti-inflammatory effects of a specific phosphodiesterase 4 inhibitor. These results demonstrate that ASA reverses anti-inflammatory effects of theophylline, and that ASA exerts its adverse effects through the inhibition of cAMP production. Our data suggest that ASA reverses lung inflammation in patients taking theophylline, although clinical evidence will be needed.
Animals ; Anti-Inflammatory Agents/*therapeutic use ; Aspirin/*therapeutic use ; Asthma/*drug therapy/*metabolism ; Blotting, Western ; Bronchoalveolar Lavage Fluid ; Cyclic AMP/*metabolism ; Enzyme-Linked Immunosorbent Assay ; Immunoprecipitation ; Mice ; Mice, Inbred C57BL ; Mice, Knockout ; Pulmonary Eosinophilia/*drug therapy/metabolism ; Theophylline/*therapeutic use

PURPOSE: Low-dose theophylline has anti-inflammatory effects. The aim of this study was to evaluate the effects of adding theophylline compared with increasing the dose of inhaled corticosteroid (ICS) on symptomatic asthma. MATERIALS AND METHODS: The associated literature was acquired through deliberate searching and selected based on the established inclusion criteria for publications. The extracted data were further analyzed by a meta-analysis RESULTS: Four randomized, controlled, parallel studies were selected. Addition of theophylline produced a greater increase of forced expiratory volume in one second as %predicted (FEV1pred) by 2.49% [95% confidence interval (CI) 1.99-3.00; z = 9.70; p < 0.001], compared with increasing the dose of ICS. There was no difference between the two treatments in terms of peak expiratory flow (PEF). CONCLUSION: Addition of theophylline to ICS has similar therapeutic effects on improving lung function as increasing the dose of ICS in the treatment of symptomatic asthma.
Adrenal Cortex Hormones/administration & dosage/*therapeutic use ; Anti-Asthmatic Agents/administration & dosage/*therapeutic use ; Asthma/*drug therapy ; Forced Expiratory Volume/drug effects ; Humans ; Randomized Controlled Trials as Topic ; Theophylline/*therapeutic use ; Treatment Outcome

OBJECTIVETo determine the prevalence of sleep-disordered breathing in patients with stable, optimally treated chronic congestive heart failure and the effect of short-term oral theophylline therapy on periodic breathing in these patients.

METHODSPatients with stable, optimally treated chronic congestive heart failure were monitored by polysomnography during nocturnal sleep. The effects of theophylline therapy on periodic breathing associated with stable heart failure were observed before and after treatment.

RESULTSPatients were divided into two groups. Group I (n = 21) consisted of individuals with 15 episodes of apnea and hypopnea [as determined by the apnea-hypopnea index (AHI)] per hour or less; Group II (n = 15, 41.7%) individuals had an index of more than 15 episodes per hour. In group II, the AHI varied from 16.8 to 78.8 (42.6 +/- 15.5) in which the obstructive AHI was 11.1 +/- 8.4 and the central AHI was 31.5 +/- 9.6. Group II had significantly more arousals (36.8 +/- 21.3 compared with 19.4 +/- 11.2 in group I) that were directly attributable to episodes of apnea and hypopnea, lower arterial oxyhemoglobin saturation (76.7% +/- 4.6% compared with 86.5% +/- 2.8%) and lower left ventricular ejection fraction (24.2% +/- 8.8% compared with 31.5% +/- 10.6%). Thirteen patients with compensated heart failure and periodic breathing received theophylline orally (at an average dose of 4.3 mg/kg) for five to seven days. After treatment, the mean plasma theophylline concentration was (11.3 +/- 2.5) micro g/ml. Theophylline therapy resulted in significant decreases in the number of AHI (20.8 +/- 13.2 vs. 42.6 +/- 15.5; P < 0.001) and the number of episodes of central apnea-hypopnea per hour (10.1 +/- 7.6 vs. 31.5 +/- 9.6; P < 0.001). Furthermore, the percentage of total sleep time during which arterial oxyhemoglobin saturation (SaO(2)) was less than 90 percent (8.8% +/- 8.6% vs. 23.4% +/- 24.1%; P < 0.05) and the arousals per hour (18.7 +/- 21.2 vs. 36.8 +/- 21.3; P < 0.05) were also lower. There were no significant differences in the characteristics of sleep or obstructive AHI before and after theophylline treatment.

CONCLUSIONSThe prevalence of sleep-disordered breathing (mainly periodic respiration or cheyne-stokes respiration with central sleep apnea) is high in patients with stable chronic congestive heart failure. The sleep-disordered breathing episodes are associated with severe nocturnal arterial blood oxyhemoglobin desaturation and excessive arousals. In these patients, oral theophylline therapy may reduce the number of episodes of central apnea and hypopnea and the duration of arterial oxyhemoglobin desaturation during nocturnal sleep.

Aged ; Chronic Disease ; Female ; Heart Failure ; complications ; Humans ; Male ; Middle Aged ; Sleep Apnea Syndromes ; drug therapy ; Theophylline ; therapeutic use ; Treatment Outcome

Acute Disease ; Asthma ; drug therapy ; Bronchodilator Agents ; administration & dosage ; adverse effects ; therapeutic use ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Infusions, Intravenous ; Male ; Theophylline ; administration & dosage ; adverse effects ; analogs & derivatives ; therapeutic use ; Treatment Outcome

OBJECTIVETo observe the role of theophylline in relieving airway symptoms and inflammation in patients with mild asthma.

METHODSFifty-six patients with mild asthma were randomly divided into treatment group (n=41) receiving oral theophylline at daily dose of 4 to 6 mg/kg for 16 weeks and control group (15 cases) without medication other than beta2 antagonist, which was administered when necessary in both groups. Peripheral blood T-lymphocyte subsets (CD3(+), CD4(+), and CD8(+)) and pulmonary function (PEF(am) and PD(20)) before and at 8 and 16 weeks during treatment were measured.

RESULTSSignificant difference was observed in CD3+ and CD4(+) T-lymphocyte subsets after medication with theophylline (P<0.05) in the patients, and PEF(am) and PD(20) were also significantly different from those of the control group (P<0.05). Theophylline significantly improved the clinical symptom scores (P<0.05) and decreased the asthma attacks.

CONCLUSIONLow-dose oral theophylline may significantly relieving airway inflammation in patients with mild asthma.

Administration, Oral ; Adult ; Asthma ; drug therapy ; immunology ; physiopathology ; Bronchodilator Agents ; administration & dosage ; therapeutic use ; Female ; Humans ; Male ; Middle Aged ; Respiratory Function Tests ; T-Lymphocyte Subsets ; drug effects ; immunology ; Theophylline ; administration & dosage ; therapeutic use ; Treatment Outcome

OBJECTIVETo evaluate the effect of traditional Chinese medicine preparations on bronchial hyperesponsiness (BHR)-induced cough.

METHODSixty patients with cough due to BHR (shown by positive bronchial provocation test) were randomly divided into Chinese medicine group (n = 30) and control group (n = 30) to receive Bufeishenqingre decoction twice a day and 100 mg theophylline sustained-release capsules twice a day for one month, respectively. The changes of the clinical symptoms were observed during the treatment and bronchial infrared imaging was performed before and after the treatment.

RESULTSThe symptoms of patients in the Chinese medicine group were more effectively alleviated than those of the control group (P < 0.05). The difference in the temperature between the bronchial lesions and the surrounding normal mucosa changed more obviously in the Chinese medicine group (P < 0.01).

CONCLUSIONBufeishenqingre decoction can relieve the symptoms and improve the abnormalities in infrared imaging of patients with BHR-induced cough.

Adult ; Bronchial Hyperreactivity ; complications ; drug therapy ; Bronchial Provocation Tests ; Bronchodilator Agents ; administration & dosage ; Cough ; drug therapy ; etiology ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Male ; Middle Aged ; Phytotherapy ; Theophylline ; administration & dosage ; Young Adult