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Two Asian patients admitted to hospital with acute severe asthma had been chewing betel nut immediately before the attacks. Arecoline, a cholinergic alkaloid, is a major constituent of Areca catechu (betel) nut and causes the euphoric effects. We sought an association between betel-nut chewing and bronchoconstriction in asthmatic patients. In vitro, arecoline caused dose-related contraction of human bronchial smooth-muscle strips, with one-tenth the potency of methacholine. In a double-blind challenge study, inhalation of arecoline caused bronchoconstriction in six of seven asthmatic patients and one of six healthy subjects; methacholine caused bronchoconstriction in all the asthmatic patients and in five controls. The geometric mean concentrations of arecoline and methacholine that caused 20% falls in the forced expiratory volume in 1 s (PC20 FEV1) in the asthmatic subjects were 5.2 mg/ml and 1.6 mg/ml, respectively. We then studied four Bengali asthmatic patients, regular users of betel nut, during a betel-nut challenge. Three showed no adverse effects, but one showed a 30% fall in FEV1 by 150 min after chewing; the effect was reproducible. In the UK, the rate of hospital admission for acute asthma is higher among Asians than among other groups in the population; betel-nut chewing may be one of several factors that affect asthma control and severity of attacks.
R F Taylor, and
N al-Jarad, and
L M John, and
D M Conroy, and
N C Barnes
July 1992,
Lancet (London, England),
R F Taylor, and
N al-Jarad, and
L M John, and
D M Conroy, and
N C Barnes
June 1991,
Papua and New Guinea medical journal,
R F Taylor, and
N al-Jarad, and
L M John, and
D M Conroy, and
N C Barnes
December 1988,
Papua and New Guinea medical journal,
R F Taylor, and
N al-Jarad, and
L M John, and
D M Conroy, and
N C Barnes
December 1998,
Veterinary and human toxicology,
R F Taylor, and
N al-Jarad, and
L M John, and
D M Conroy, and
N C Barnes
September 1985,
IARC monographs on the evaluation of the carcinogenic risk of chemicals to humans,
R F Taylor, and
N al-Jarad, and
L M John, and
D M Conroy, and
N C Barnes
January 2002,
Addiction biology,
R F Taylor, and
N al-Jarad, and
L M John, and
D M Conroy, and
N C Barnes
October 1996,
Psychological reports,
R F Taylor, and
N al-Jarad, and
L M John, and
D M Conroy, and
N C Barnes
March 2004,
Journal of the European Academy of Dermatology and Venereology : JEADV,
R F Taylor, and
N al-Jarad, and
L M John, and
D M Conroy, and
N C Barnes
January 1984,
Papua and New Guinea medical journal,
R F Taylor, and
N al-Jarad, and
L M John, and
D M Conroy, and
N C Barnes
December 1988,
South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde,
