Nociceptive mechanisms modulate ozone-induced human lung function decrements

We have previously suggested that ozone(O₃)-induced pain-relatedsymptoms and inhibition of maximal inspiration are due to stimulationof airway C fibers (M. J. Hazucha, D. V. Bates, and P. A. Bromberg.J. Appl.Physiol. 67: 1535-1541, 1989). If this were so,pain suppression or inhibition by opioid-receptor agonists shouldpartially or fully reverseO₃-induced symptomatic and lung functional responses. The objectives of this study were to determine whether O₃-induced pain limitsmaximal inspiration and whether endogenous opioids contribute tomodulation of the effects of inhaledO₃ on lung function. Theparticipants in this double-blind crossover study were healthyvolunteers (18-59 yr) known to be "weak" (WR;n = 20) and "strong"O₃ responders (SR;n = 42). They underwent either two 2-hexposures to air or two 2-h exposures to 0.42 parts/millionO₃ with moderate intermittentexercise. Immediately afterpost-O₃ spirometry, the WR wererandomly given either naloxone (0.15 mg/kg iv) or saline, whereas SRrandomly received either sufentanil (0.2 µg/kg iv) or saline.O₃ exposure significantly(P < 0.001) impaired lung function.In SR, sufentanil rapidly, although not completely, reversed both thechest pain and spirometric effects (forced expiratory volume in 1 s;P < 0.0001) compared with saline.Immediate postexposure administration of saline or naloxone had nosignificant effect on WR. Plasma -endorphin levels were not relatedto an individual's O₃responsiveness. Cutaneous pain variables showed a nonsignificantweak association with O₃responsiveness. These observations demonstrate that nociceptive mechanisms play a key role in modulatingO₃-induced inhibition ofinspiration but not in causing lack of spirometric response toO₃ exposure in WR.