Search

The influence of cigarette smoking on the pathophysiology of asthma in the elderly remains controversial. In this study, the inluence of cigarette smoking on IgE - mediated allergy including the generation of leukotrienes B4 (LTB4) and C4 (LTC4) was examined in forty asthmatics over the age of 70 years (20 ex-smokers and 20 never-smokers), and 20 patients with pulmonary emphysema over age 70 (all ex - smokers). The frequency of patients with serum IgE more than 200 IU/ml was significantly larger in smoking asthmatics than in non - smoking asthmatics. The incidence of patients with positive RAST score for inhalant allergens, was also significantly higher in patients with a history of smoking than in those without a smoking history. There were no significant differences in the frequency of patients with positive RAST and those with serum IgE more than 200 IU/ml between non-smoking asthmatics and patients with pulmonary emphysema. The generation of leukotriene B4 (LTB4) by leukocytes was significantly more increased in ex-smokers than in never-smokers in the elderly asthmatics. The results suggest the possibility that cigarette smoking enhances IgE - mediated allergy in elderly patients with asthma., 高齢者喘息の病態に対する喫煙の影響については,なお不明な点が多い｡本研究では,70歳以上の気管支喘息40例(喫煙歴20年以上の症例20例,非喫煙症例20例)および70歳以上の肺気腫20例(全例喫煙者)を対象に,IgE-mediatedallergy(LTB4,LTC4の産生を含む)に対する喫煙の影響について検討した｡血清IgE値が200IU/ml以 上を示す症例の頻度は,喘息の喫煙例で非喫煙例や肺気腫症例と比べ有意に高い値を示した｡吸入抗原に対する特異的IgE抗体が陽性を示す症例の頻度は,喘息の喫煙例で非喫煙例や肺気腫に比べ有意に高い値を示した｡しかし,血清IgEが200IU/ml以上の症例の頻度およびRAST陽性例の頻度は,喘息の非喫煙例と肺気腫例の間には有意 の差は見られなかった｡LTB4の産生は,喘息の喫煙例で,非喫煙例と比べ有意の亢進が見られた｡また,肺気腫例では,喘息の非喫煙例に比べ,有意に高い産生が見られた｡しかし,LTC4の産生には喘息の喫煙例,非喫煙例,肺気腫例の間に有意の差は見られなかった｡

The generation of leukotrienes B4 (LTB4) and C4 (LTC4) by leucocytes stimulated with Ca ionophore A23187 was examined in 67 patients with asthma. 1. The generation of leukotriene B4 (LTB4) by leucocytes was significantly more increased in patients with asthma than in those with pulmonary emphysema (PE) and healthy subjects. The generation of leukotriene C4 (LTC4) was also signficantly more increased in patients with asthma compared to the generation in those with PE and healthy subjects. The generation of both LTB4 and LTC4 was significantly more increased in patients with PE than in healthy subjects. 2. The generation of both LTB4 and LTC4 was larger in patients with asthma over age 70 than in those of other age groups, however, the difference was not significant. 3. The generation of LTC4 was significantly higher in attack stage than in non-attack stage in all age groups of patients with asthma, however, the generation of LTB4 was not significantly different between the two stages. 4. Bronchial hyperresponsiveness to methacholine in patients with asthma tended to decrease with aging, and the bronchial hyperresponsiveness was to a certain extent correlated with the generation of LTB4, but not LTC4. 5. The generation of LTC4 was correlated with value of FEV1.0%. These results may suggest that both LTB4 and LTC4 participate in the pathophysiology of asthma in the elderly., 気管支喘息67例を対象に, Ca ionophoreA23187刺激時の白血球からのロイコトリエンB4(LTB4)およびC4 (LTC4)の産生を観察し,高齢者喘息の臨床病態におけるLTB4,LTC4の役割について検討した｡ 1.LTB4の産生は,気管支喘息において肺気腫および健康人に比べ有意に高い値を示した｡LTC4の産生も同様に気管支喘息において,肺気腫,健康人に比べ有意に高い値30を示した｡LTB4,LTC4いずれの産生も,肺気腫症例において健康人と比べ有意に高い値が観察された。 2.LTB4,LTC4の産生は,70才以上の喘息症例において,他の年齢層の症例に比べより高い値が示されたが,推計学的な有意差は見られなかった｡ 3.高齢者を含めいずれの年齢層の気管支喘息においても,LTC4の産生は発作時に,非発作時に比べ有意の亢進が見られたが,LTB4に関しては発作時,非発作時の間に有意の差は見られなかった｡ 4.気道の過敏性は,年齢が高くなるにつれて低下する傾向が見られた｡そして,この気道の過敏性はLTB4産生とある程度関連していることが示されたが,LTC4との関連は見られなかった｡ 5.FEV1.0%値は,ある程度LTC4産生亢進と関連があることが示された｡ 以上の結果より,70才以上の喘息においても,LTB4,LTC4がその発作時病態に重要な役割を果していることが示唆された｡

Changes in the generation of leukotrienes B4 (LTB4) and C4 (LTC4) by leucocytes after spa therapy were examined in 30 patients with asthma. 1. The efficacy of spa therapy was marked in 8 (26.7%), and moderate in 16 (53.3%) of 30 patients with asthma, and slight or no efficacy of the therapy was observed in the residual 6 patients (20.0%). 2. Bronchial reactivity to methacholine was the highest in patients with slight or no efficacy of spa therapy, however. there were no significant differences among the three groups classified by clinical efficacy. 3. The generation of LTC4 was significantly higher in patients with slight or no efficacy compared with the generation in those with marked (p, 気管支喘息30例を対象に,温泉療法によるロイコトリエンB4 (LTB4),C4 (LTC4)産生の変動および気道過敏性と臨床効果との関連について検討を加えた｡ 1.温泉療法の臨床効果は,著効8例(26.7%),有効16例(53.3%),やや有 効あるいは無効6例(20.0%)であった｡ 2.メサコリンに対する気道過敏性は,やや有効あるいは無効例で高い傾向が見られたが,著効,有効例と比べ有意の差は見られなかった。 3.LTC4産生はやや有効あるいは無効例において著効例(P

The generation of leukotrienes B4 (LTB4) and C4 (LTC4) by leucocytes stimulated with Ca ionophore A23187 was examined in 16 patients with asthma (8 with atopic and 8 with nonatopic asthma) and 12 healthy controls. 1. The LT84 generation by leucocytes was not significantly different between patients with asthma and healthy controls. The generation of LTC4 was significantly larger in patients with asthma than in healthy controls. The LTC4 generation was also significantly larger in patients with attacks (58.4 ± 38.5 ng/5x10(6) cells) than in those without attacks (23.3 ± 25.9 ng/5x10(6) cells)(p, 気管支喘息16例(アトピー型喘息8例,非アトピー型喘息8例)を対象に,Ca ionophore A23187 刺激時の末梢血白血球のロイコトリエンB4(LTB4)およびC4(LTC4)産生能について検討した｡1.LTB4産生能は,喘息症例と健康人 の間に有意の差は見られなかった｡LTC4産生能は,健康人に比べ喘息症例で有意に高い傾向が見られた｡また,喘息症例では,非発作時(23.3±25.9ng/5xl0(6)cells)に比べ発作時(58.4±38.5ng/5xl0(6)cells)に有意に高い値を示した(p

To analyze the pathophysiological changes ot the airways in emphysema, bronchial responsiveness and the generation of leukotrienes B4 (LTB4) and C4 (LTC4) by peripheral leucocytes were examined in 22 patients with emphysema. The subjects were divided into two groups according to the presence or absence of IgE antibodies against inhalant allergens; RAST positive group and RAST negative group. 1. Smoking history, mean CT number and mean maximum % low attenuation area (% LAA), 肺気腫患者の気道病変を解析する目的で,22例の肺気腫患者を対象に,その気道反応および白血球のロイコトリエンB4,C4産生能について検討を加えた｡この際対象症例はIgE抗体の有無によってRAST陽性症例RAST陰性症例に分類された｡1.喫煙歴,平均CT値,high resolution computed tomography(HRCT)上の-950HU以下の% low attenuation area(% LAA),DLcoなどの値は,いずれも対象症例が高度な気腫化病変を有してい ることを示した｡2.血清IgE値は,RAST陽性例で陰性例に比べ有意の高値を示した｡3.β受容体刺激薬吸入後のFEV1.0の増加は,RAST陽性例で陰性例に比べ高度であった｡そして,吸入後のFEV1.0が15%以上の増加を示した症例は,RAST陽性例では9例中4例(44.4%),陰性例では12例中2例(16,7%)であった｡4.白血球のLTC4産生量は,RAST陽性例で陰性例に比べ有意に高い値であったが,LTB4産生は両者間に有意の差は見られなかった｡以上の結果より,IgEにmediateされるアレルギー反応が,肺気腫患者 の気道反応に関与している可能性が示唆された。

The generation of leukotrienes B4 (LTB4) and C4 (LTC4) by peripheral leukocytes stimulated with Ca ionophore A23187 was examined in 17 patients with pulmonary emphysema. They were divided into three groups according to the mean CT number; A (, 肺気腫患者17名を対象として,カルシウムイオノフォアA23187による末梢血白血球からのロイコトリエンB4(LTB4), ロイコトリエンC4(LTC4)の産生能の検討を行った｡対象は高分解能CTによる平均CT値によってA(

N-3 fatty acids, such as fish oil, have been reported to have some beneficial effects in patients with bronchial asthma by suppressing leukocyte function, followed by reduction of the need for pharmacologic agents. To examine the effects of dietary supplementation with perilla seed oil rich in α-linolenic acid (ALA), 23 patients with asthma took corn oil rich in linoleic acid (LA) for the former two weeks, perilla seed oil for the later two weeks. The asthmatic patients were classified into two groups by the changes of the generation of leukotrienes B4 (LTB4), C4 (LTC4), and B5 (LTB5) during the two courses of dietary modification: one was sensitive to dietary modification, and the other was insensitive to dietary supplementation. We compared the two groups in clinical characteristics. Significant differences were observed in peak flow (PEF), forced expiratory volume in one second (FEV1.0), IgE, sex, obesity index (OI), concentration of serum total cholesterol, albumin, low density lipoprotein {LDL)-cholesterol, β-lipoprotein and phospholipids between two groups. This study indicated that these factors influence the generation of LTB4, C4 and B5 of asthmatic patients in dietary supplementation., 気道への炎症性白血球の集合が気管支喘息の病態に関わっている。魚油などのn-3系脂肪酸が白血球の機能を抑制することにより気管支喘息患者に良好な効果をもたらし,薬剤の必要性を減じたとの報告がなされている｡α-リレノン酸を豊富に含有するエゴマ油食の効果を調べるため,気管支喘息患者23名に2コースの食事-リノール酸の豊富なコーン油食を2週間摂取後,エゴマ油食を2週間-を摂取してもらった｡喘息患者は2コースの食事間のロイコトリエンB4(LTB4),CA(LTC4),B5(LTB5)の変化から2群-1群は食事に対し感受性のある群,もう1つは感受性の無い群-に分類した｡我々はこの2群を臨床的に検討したところ,ピークフロー(PEF),1秒量(FEV10),IgE,性別,肥満率(OⅠ),血清総コレステロール,アルブミン,低比重リポ蛋白(LDL)-コレステロール,β-リポ蛋白,リン脂質において2群間に有意差が認められた｡今回の研究から,これらの因子が,喘息患者において,LTB4,LTC4,LTB5の産生に対する食事療法の効果に影響を及ぼしていることが示唆された｡

In recent years, it has been noted that there is a close correlation between leukotrienes and late asthmatic reaction (LAR). In this study, effects of dietary supplementation with perilla seed oil rich in alpha-linolenic acid, which is speculated to affect the generation of leukotrienes through metabolism of arachidonic acid (AA), were evaluated in 6 patients with asthma. The symptoms and ventilatory function were improved after 2-week dietary supplementation with perilla seed oil. The generation of LTB4 and LTC4 by peripheral leucocytes stimulated with Ca ionophore A23187 was significantly suppressed by the dietary supplementation (LTB4 and LTC4 ; p, 近年,ロイコトリエンと遅発型気管支反応(LAR)との密接な関連が注目されている｡本論文では,アラキドン酸(AA)代謝を通してロイコトリエン合成に関与すると推定される,αリノレン酸を多く含むエゴマ油による食事療法の臨床効果を,気管支喘息を対象に検討した｡臨床症状および換気機能は,2週間のエゴマ油投与で明らかな改善差傾向を示した｡Ca ionophore A23187刺激時の白血球のLTB4およびLTC4産生は,エゴマ油投与により,投与前に比べ有意の減少を示した(p