Chest ACCP Member Benefits
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

Guest Access | Sign In via User Name/Password
This Article
Right arrow Full Text Free
Right arrow Full Text (PDF) Free
Right arrow Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Article Archive
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via ISI Web of Science (5)
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Alvarez-Puebla, M. J.
Right arrow Articles by Tabar-Purroy, A. I.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Alvarez-Puebla, M. J.
Right arrow Articles by Tabar-Purroy, A. I.
(Chest. 2001;119:120-127.)
© 2001 American College of Chest Physicians

Determinants of Allergen-Induced Late Bronchial Responses in Mild Asthmatics*

María J. Alvarez-Puebla, MD, PhD; Jose M. Olaguibel-Rivera, MD, PhD; Eduardo Urbiola-Marcilla, MD, PhD; Blanca E. Garcia, MD, PhD and Ana I. Tabar-Purroy, MD, PhD

* From the Allergy Department (Dr. Alvarez-Puebla), Hospital de León, León, Spain; and the Allergy Department (Drs. Olaguibel-Rivera, Garcia, and Tabar-Purroy) and Pathology Department (Dr. Urbiola-Marcilla), Hospital Virgen del Camino, Pamplona, Spain.

Correspondence to: María J. Alvarez-Puebla, MD, PhD, Puebla C/Padre Arintero, n°11, 1°C, 24001 León, Spain; e-mail: mapuebla{at}terra.es

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 FEV1 values >= 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.

Key Words: airway inflammation • allergen bronchial provocation test • asthma • bronchial hyperresponsiveness • Dermatophagoides pteronyssinus • eosinophil cationic protein • eosinophils • late-phase response






HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 2001 by the American College of Chest Physicians.