Efficacy and Safety of Beta-adrenoceptor Inverse Agonist, Nadolol, in Mild Asthma

Inclusion Criteria:

Individuals who meet all of the following criteria are eligible for enrollment as study
participants:

1. Males and females with physician-diagnosed asthma between the ages of 18- 60.

2. Pre-bronchodilator FEV1 80% or greater than the predicted value

3. Baseline PC20 (based on FEV1) ≤ 4 mg/ml on methacholine challenge test.

4. Asthma Control Questionnaire Score (ACQ) <1.25

5. Baseline blood pressure ≥ 110/65mm Hg

6. Baseline pulse rate ≥ 60 beats/min.

7. Never-smoker or former-smoker < 10 pack.year and has not smoked within 1 year.

8. Able to complete diary cards and comply with study procedures.

9. Females of childbearing age may participate only if they have a negative pregnancy
test, are non-lactating, and agree to practice an adequate birth control method
(abstinence, combination barrier and spermicide, or hormonal) for the duration of the
study.

Exclusion Criteria:

Subjects who meet ANY of the following criteria are not eligible for enrollment:

1. Inability or unwillingness of the participant to give written informed consent

2. History of upper/lower respiratory tract infection or asthma exacerbation requiring
systemic steroids within 6 weeks of Visit 1

3. Use of rescue medication (e.g., albuterol) more than twice per week during the week
preceding Visit 1 excluding the use of such medication as preventative prior to
exercise.

4. History of hospitalization for asthma in the preceding year

5. History of intubation for asthma

6. Currently diagnosed with chronic obstructive pulmonary disease (COPD)

7. Currently taking any beta-blocker medication

8. History of adverse reaction or allergy to any beta-blocker medication

9. History of neurological, hepatic, renal, or other medical conditions that may
interfere with the interpretation of data or the patient's participation in the study
or may increase safety concerns

10. Current diabetes or hyperthyroidism

11. History of cardiovascular diseases including uncontrolled hypertension (BP >160/100),
ischemic heart disease, congestive heart failure, valvular heart disease or
cardiomyopathy

12. Known allergy or sensitivity to atropine or ipratropium bromide

13. Abnormal entry laboratory values at baseline except for the following tests, where
values outside the normal limits will be acceptable as follows: Hct ≥ 30%, platelet
count > 100,000, ALT and AST < 1.5 x upper normal limit

14. Known bleeding disorders, platelet count <100,000, PT or PTT > 1.5 x normal control
(if participating in bronchoscopy sub-study)

15. Known allergy to lidocaine (if participating in bronchoscopy sub-study)

16. Documented or self-reported current history of alcoholism or drug abuse

17. Participation in another research trial within 30 days of starting this trial

18. Unwillingness or inability to comply with study procedures

19. Inability to swallow the study medication capsule

20. Use of any exclusion medication within the time period specified

21. Pregnant or nursing

22. Receiving allergen immunotherapy (desensitization injections)