BACKGROUND: Immediate skin reactions to allergens are influenced by several factors, such as the amount of administered allergen, the level of specific IgE, releasability of mast cells and hyperresponsiveness of the target organ. METHODS: For the evaluation of factors influencing immediate skin response to intradermal allergen administration, we measured the wheal size 15 min after intradermal injection of 0.01-0.02 ml of the following agents: whole-body extract of Dermatophagoides farinae, 1,000 allergy units/ml; histamine, 0.1 mg/ml, and codeine sulfate, 0.09% in saline, and determined total IgE level, specific IgE and IgG subclass antibodies to D. farinae in 53 patients with respiratory allergy. RESULTS: Multiple regression analysis for factors influencing wheal size after intradermal injection of D. farinae, specific IgE antibody level to D. farinae and wheal size after intradermal administration of histamine showed statistically significant results (R2 = 0.42739, p = 0.0000; R2 = 0.50243, p = 0.0185, respectively). Multiple regression analysis for factors influencing wheal size after intradermal administration in the group with high levels of specific IgE to D. farinae (RAST class 3 or more) showed that wheal size after intradermal administration of codeine was the only factor exerting a statistically significant influence (p = 0.0119). CONCLUSION: Based on the above results, we can state that immediate responses to intradermal allergen administration were influenced by the level of specific IgE and hyperresponsiveness of the target organ to histamine, but that the immediate skin allergic responses in the presence of high levels of specific IgE were partially but significantly influenced by the releasability of skin mast cells.

Adult↗

PubMedDate not supplied

Eosinophil count and eosinophil cationic protein concentration of induced sputum in the diagnosis and assessment of airway inflammation in bronchial asthma.

Measurement of eosinophil percentages and ECP concentration in induced sputum may be useful in the diagnosis and assessment of the variability of airway inflammation in bronchial asthma (BA). To evaluate the usefulness of sputum eosinophil counts and ECP concentrations in the diagnosis of BA, we measured these parameters in 68 patients with respiratory complaints. In addition, we followed-up 14 BA patients with variable airflow limitation for 45.4 +/- 10.4 days. The BA group (n = 41) showed a higher percentage of sputum eosinophilia (24.5 +/- 7.6 vs. 2.2 +/- 2.9%, p < 0.001) and a higher level of sputum ECP (198.2 vs. 90.6 micrograms/L, p < 0.05) than those in the nonasthmatic group (NBA, n = 27). The sensitivity and specificity of sputum eosinophilia (> or = 5%) for the diagnosis of BA were 85.4% and 92.6%, respectively, which were better than the sensitivity (68.3%) and specificity (55.5%) of the increased level of sputum ECP (> or = 100 micrograms/L). Patients with moderate-to-severe persistent BA had a higher percentage of sputum eosinophil (n = 23, 34.6 +/- 10.6%) than those of mild persistent BA (n = 18, 10.7 +/- 5.2%, p < 0.01), but we could not find significant difference in ECP levels between mild persistent and moderate-to-severe persistent asthma. The percentages of sputum eosinophilia showed a moderate correlation with ECP (r = 0.4358, p < 0.01) and with the peak expiratory flow rate (PFR, r = -0.4746, p < 0.01) but sputum ECP did not correlate with PFR. In 14 BA patients who were followed, there was a relationship between changes of PFR and the percentage of sputum eosinophil (r = -0.7238, p < 0.01), but the change of PFR did not correlate with the change of sputum ECP levels. These results suggest that the sputum eosinophil count and sputum ECP level could be helpful in the diagnosis of BA, but that sputum ECP is not satisfactory for the assessment of variability of airway eosinophilic inflammation during the initial anti-inflammatory management of BA.

Adult↗

PubMedDate not supplied

Linking past to present.

Explore the source record for details and available documents.

Aged↗

PubMedDate not supplied

Mental handicap nursing. Doubly disadvantaged.

Explore the source record for details and available documents.

Aged↗

PubMedDate not supplied

High-resolution computed tomography in patients with bronchial asthma: correlation with clinical features, pulmonary functions and bronchial hyperresponsiveness.

The high-resolution computed tomography (HRCT) studies for bronchial asthma (BA) have revealed abnormal radiologic findings such as bronchial wall thickening, bronchiectasis, emphysema and mosaic pattern of lung attenuation. But the clinical significance of these findings are not yet clarified. In this study, we quantified the bronchial wall thickness and evaluated HRCT features in 57 BA subjects (338 bronchi) who had precipitating factors of irreversible airway remodeling, 19 COPD subjects (70 bronchi) and 10 healthy subjects (23 bronchi). Then we correlated HRCT findings with the clinical features, pulmonary functions and methacholine PC20 (PC20M) and studied their clinical significance. The bronchial wall for BA was about 1.48 mm thicker than that for COPD and about 2.34 mm thicker than for healthy controls (p < 0.0001, respectively). But the individual mean ratio of bronchial wall thickness to luminal diameter (BWT/LD) in asthmatics did not correlate with the clinical features, lung functions and PC20M. Abnormal HRCT findings, such as bronchiectasis (17.5%), emphysema (5.3%) and mosaic pattern of lung attenuation (17.5%) were found in BA. These findings were more common in BA with moderate to severe airflow limitation (FEV1 < 80%, p < 0.05) and patients with these changes had a more prolonged history of asthma (p < 0.05). PC20M was higher in BA with these abnormal changes (p < 0.001) but these patients' FEV1 (p < 0.05), FEF25-75 (p < 0.05) and specific airway conductance (p < 0.05) were lower than those having BA without such findings. In this study we showed that the bronchial wall was more significantly thickened in BA but that it did not correlate well with the clinical features, lung functions and PC20M. Additionally, patients having BA with abnormal airway and air space HRCT findings had a prolonged history of asthmatic symptoms, loss of lung functions and decreased bronchial hyperresponsiveness. These results suggested the possibility that HRCT can be used for the differentiation of BA from COPD or healthy controls. Furthermore, patients having BA with abnormal HRCT changes demonstrate poor lung function and less hyperreactive bronchi than those without. We concluded that HRCT may be useful for the prognosis and treatment of bronchial asthma cases who have the precipitating factors of irreversible airway remodelling.

Adult↗