1. Determinants of allergen-induced late bronchial responses in mild asthmatics.
- Author
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Alvarez-Puebla, María J., Olaguibel-Rivera, Jose m., Urbiola-Marcilla, Eduardo, Garcia, Blanca E., Tabar-Purroy, Ana I., Alvarez-Puebla, M J, Olaguibel-Rivera, J M, Urbiola-Marcilla, E, Garcia, B E, and Tabar-Purroy, A I
- Subjects
ASTHMA diagnosis ,BRONCHIAL provocation tests - Abstract
Study Objective: To examine the baseline factors influencing the occurrence and magnitude of immediate- and late-phase responses in asthmatic patients after an allergen-induced bronchial provocation test (A-BPT).Design: Cross-sectional analysis in a homogenous group of 31 mild, Dermatophagoides pteronyssinus-allergic patients with asthma.Setting: Allergy Department, Hospital Virgen del Camino, Pamplona, Spain.Interventions and Measurements: Patients completed an asthma symptom questionnaire and underwent skin tests, sputum induction, and methacholine bronchial provocation test. The A-BPT was performed on a separate day. Sputum cell profile and eosinophil cationic protein (ECP), tryptase, albumin, and interleukin-5 levels were quantified in the entire sputum supernatant. Assays were done for eosinophils in blood, and/or ECP, and total and specific IgE levels in serum. Exposure to D pteronyssinus major allergens (Der p1 and Der 2) was measured by an assay based on monoclonal antibodies.Results: A-BPT findings were positive in all patients, and late-phase responses were detected in 29%. Late responders were exposed to higher levels of Der p1 (p = 0.028), had greater levels of ECP (p = 0.007) and albumin (p = 0.019) in sputum, and showed a trend toward higher lymphocyte numbers (p = 0.053) in sputum than isolated early responders. The allergen-induced provocative dose that induced a fall in FEV(1) values > or =20% from the postdiluent values correlated with bronchial hyperresponsiveness (r = 0.36). The late-phase response magnitude correlated with Der p1 exposure (r = 0.49) and showed a trend toward correlation with sputum ECP levels (r = 0.38).Conclusion: Factors involved in the development of allergen-induced immediate- and late-phase responses are different. Allergen natural exposure might prime the infiltration of the airway by activated inflammatory cells enhancing the appearance and the severity of late-phase responses. [ABSTRACT FROM AUTHOR]- Published
- 2001
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