Wheal and flare responses to muscl relaxants in humans

J. H. Levy, David Adelson, B. Walker

Research output: Contribution to journalArticle

29 Citations (Scopus)

Abstract

Chemically and pharmacologically unrelated molecules release histamine in humans to produce both cutaneous and systemic responses. It has been suggested that molecular changes in the new benzylisoquinoline-derived muscle relaxant, atracurium, make it less likely to cause histamine release. We therefore injected volunteers intradermally with equimolar concentrations of various muscle relaxants, morphine, papaverine (a benzylisoquinoline), and histamine, to evaluate the relative ability of these drugs to cause wheal and flare responses, and mast-cell degranulation. There were no significant differences in wheal and flare responses among the three benzylisoquinoline-derived muscle relaxants, d-tubocurarine, metocurine, and atracurium. The cutaneous effects of morphine were significantly greater than those of the benzylisoquinoline muscle relaxants, suggesting both direct vascular changes and histamine release. Papaverine injection was followed by a significant wheal but no flare. Skin biopsies from vecuronium- and papaverine-induced wheals revealed normal intact mast-cell granules, suggesting a direct cutaneous vascular response rather than histamine release. Skin biopsies after morphine and atracurium injections revealed mast-cell degranulation. All evaluated benzylisoquinoline muscle relaxants are equipotent histamine releasers at equimolar concentrations. A hydrogenated, benzylisoquinoline-nitrogen-containing ring, present in atracurium but not in papaverine, appears to be the molecular conformation responsible for mast-cell degranulation by atracurium.

Original languageEnglish (US)
Pages (from-to)302-308
Number of pages7
JournalAgents and Actions
Volume34
Issue number3-4
DOIs
StatePublished - Nov 1991
Externally publishedYes

Fingerprint

Benzylisoquinolines
Atracurium
Histamine
Papaverine
Histamine Release
Muscle
Cell Degranulation
Mast Cells
Muscles
Skin
Morphine
Biopsy
Blood Vessels
Molecular Conformation
Vecuronium Bromide
Tubocurarine
Injections
Conformations
Volunteers
Nitrogen

ASJC Scopus subject areas

  • Toxicology
  • Pharmacology (medical)

Cite this

Wheal and flare responses to muscl relaxants in humans. / Levy, J. H.; Adelson, David; Walker, B.

In: Agents and Actions, Vol. 34, No. 3-4, 11.1991, p. 302-308.

Research output: Contribution to journalArticle

Levy, J. H. ; Adelson, David ; Walker, B. / Wheal and flare responses to muscl relaxants in humans. In: Agents and Actions. 1991 ; Vol. 34, No. 3-4. pp. 302-308.
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