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Autonomic control of airway smooth muscle and airway secretions.

Introduction My interest in the autonomic nervous system was stimulated by Dr. Comroe during my research training under his guidance. As a cardiovascular fellow, I learned of the many pulmonary, as well as cardiovascular, effects of nicotine (1). My next "exposure" to lungs occurred in a physiology class. The medical students and I found that inhalation of cigarette smoke increased airway resistance (2). To my astonishment, atropine sulfate (a drug purported to have no significant effects on airways) prevented bronchoconstriction after cigarette smoke. Dr. Comroe encouraged me to engage in more basic studies to determine the nervous pathways involved, and before long, I was a genuine pulmonary research fellow! Dr. Comroe's conviction that research knowledge should be applied to problems of patients influenced our studies on airways, and soon we were studying mechanisms in asthma. It is these studies relating to asthma that I will describe. Asthma is a disease characterized by recurrent attacks of bronchoconstriction, due largely to contraction of airway smooth muscle. In addition, some asthmatic patients develop progressive bronchial narrowing that is relatively unresponsive to bronchodilator drugs. Postmortem examination of the airways in such patients reveals obstruction of airways due to inspissation of mucus. I will present evidence that the cho-