Volume 128, Issue 4, Pages 3038-3047 (October 2005) Salmeterol Does Not Alter Increased Bronchial Responsiveness Caused by Organic Dust Exposure  Ek Alexandra , PhD, Palmberg Lena , MD, PhD, Sundblad Britt-Marie , PhD, Larsson Kjell , MD, PhD  CHEST  Volume 128, Issue 4, Pages 3038-3047 (October 2005) DOI: 10.1378/chest.128.4.3038 Copyright © 2005 The American College of Chest Physicians Terms and Conditions

Figure 1 PEF before and after exposure in a swine barn in healthy subjects who inhaled one dose of placebo (n = 6) or one dose of salmeterol (100 μg, n = 6) 1 h prior to exposure (part 2). Results are presented as mean and SEM. *p < 0.05 and **p < 0.01 compared with pre-exposure values. There is no significant difference between the group (F = 2.0; p = 0.08). 2w = 2 weeks. CHEST 2005 128, 3038-3047DOI: (10.1378/chest.128.4.3038) Copyright © 2005 The American College of Chest Physicians Terms and Conditions

Figure 2 Bronchial responsiveness to methacholine before medication and after exposure to dust in healthy subjects treated with placebo (n = 8) or salmeterol (50 μg bid, n = 8) for 2 weeks (part 1). Top, A: PC20; horizontal lines indicate median values, and horizontal dashed line represents the highest inhaled concentration of methacholine (64 mg/mL). One subjects did not attain a 20% decrease in FEV1 when the maximum (Max) concentration was reached, but had a > 15% FEV1 decline (part 2). Bottom, B: The dose-response slopes are presented as median and interquartile ranges. No significant difference between the groups (p = 0.2, F = 2.2, ANOVA on log-transformed slope data). p values indicate preexposure and postexposure comparisons. CHEST 2005 128, 3038-3047DOI: (10.1378/chest.128.4.3038) Copyright © 2005 The American College of Chest Physicians Terms and Conditions

Figure 3 Bronchial responsiveness to methacholine before and after exposure to dust in healthy subjects treated with one dose placebo (n = 6) or one dose of 100 μg of salmeterol (n = 6; part 2). Top, A: Horizontal lines indicate median values, and horizontal dashed line represents the highest inhaled concentration of methacholine (32 mg/mL). Three subjects had a < 15% FEV1 decline when the maximum concentration was reached and were given a PC20 value of 128 mg/mL (light gray circles). In two subjects, FEV1 fell between 20% and 15% after inhalation of the maximum concentration, and PC20 was calculated by extrapolation (log-extrapolated from the last two points). For statistical calculations, nonextrapolated values were used. Bottom, B: Dose-response slopes are presented as median and interquartile ranges. No significant difference between the groups (p = 0.14, F = 2.5; ANOVA on log-transformed data); p values indicate preexposure and postexposure comparisons. See Figure 3 legend for expansion of abbreviation. CHEST 2005 128, 3038-3047DOI: (10.1378/chest.128.4.3038) Copyright © 2005 The American College of Chest Physicians Terms and Conditions

Figure 4 Top, A: PC20 of eight healthy subjects after inhaling one dose of placebo or salmeterol (100 μg) 2 h or 8 h before the methacholine provocation in a cross-over design (part 3). Horizontal lines indicate median values. Bottom, B: Corresponding dose-response slopes are presented as median and 25 to 75th percentiles; p values indicate the PC20 differences between salmeterol and placebo inhalations. There were no significant differences between the slope at 2 h or 8 h (p = 0.5, F = 0.4). CHEST 2005 128, 3038-3047DOI: (10.1378/chest.128.4.3038) Copyright © 2005 The American College of Chest Physicians Terms and Conditions