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The technique of broncho-alveolar lavage (BAL) can be used without difficulty in asthmatic patients. The authors studied 17 patients with high eosinophil counts (greater than 20 p. 100) and followed them up for 6 to 12 months. An increase in total cell counts in BAL was observed which was in direct correlation with the percentage of eosinophils; chest X-ray showed no evidence of pulmonary infiltration in any of the cases; 9 patients were steroid dependent. These observations indicate that radiological pulmonary infiltrates in asthmatic patients which is a real disease entity does not cover the whole spectrum of deep pulmonary changes in this condition. Broncho-alveolar lavage is a valuable mean of assessing the degree of local eosinophilia to compare the inflammatory disease of the distal airways with the rest of the asthmatic changes. It may contribute to a better understanding of the asthmatic syndrome; many facets of which are indeed still obscure.

The hyperreactivity-modulating effect of SCH 1000 and fenoterol was tested in two groups of 10 patients. The drugs were administered at random, in simple blind fashion. Baseline pulmonary function was in the range of predicted values for all patients. One group received 80 micrograms of SCH 1000. When the drug was inhaled after carbachol challenge, pulmonary function returned to normal values in all patients. When the drug was inhaled before challenge, a shift to the right of the dose-effect curves was observed in all patients but 1. The other group received 800 micrograms of fenoterol. When the drug was administered after carbachol challenge, all 10 patients returned to baseline within 10 min. When it was given before carbachol challenge, a shift to the right of the dose-effect curves was observed in 9 patients out of 10. SCH 1000 and fenoterol induced an effective protection against carbachol, increasing the PD20 and shifting the dose-effect curves to the right in most of the asthmatics. In 2 patients, 80 micrograms of SCH 1000 or 800 micrograms of fenoterol seemed too low in order to achieve a complete protective effect.