Lieutier-Colas Florence, Purohit Ashok, Meyer Pierre, Fabries Jean-François, Kopferschmitt Marie-Christine, Dessanges Jean-Francois, Pauli Gabrielle, de Blay Frédéric
Service de Pneumologie, Hôpital Civil and Service de Biostatistiques et Informatique Médicale, Faculté de Médecine, Strasbourg, France.
Am J Respir Crit Care Med. 2003 Apr 15;167(8):1077-82. doi: 10.1164/rccm.2204037.
Our aim was to compare bronchial responses to major cat allergen (Fel d 1) in individuals with intermittent asthma sensitized to cats (19 subjects) according to the droplet particle size. We used three nebulizers, which delivered particles with mass median aerodynamic diameters of 1.4, 4.8, and 10.3 microm. A dosimeter nebulizer was used. The cat allergen was diluted to obtain the same amount of Fel d 1 per puff with each nebulizer. Each patient underwent three methacholine bronchial challenge tests (BCT), each followed 24 hours later by a cat allergen BCT, each performed with a different nebulizer (randomly selected each time, with patient and tester always blinded). Subjects did not differ for methacholine responsiveness, FEV1, mean forced expiratory flow during the middle half of the FVC (FEF25-75), PEF, or dyspnea (Borg scale) before any of the three cat BCTs. Cat allergen PD20 was 271 ng of Fel d 1 with the 1.4 microm nebulizer, 46 ng with the 4.8 microm nebulizer, and 13.5 ng with the 10.3 microm nebulizer (p = 0.00001). Inhalation of small particles (1.4 microm) resulted in significantly lower FEF25-75 24 hours after provocation than large particles did. In conclusion, immediate bronchial response appears to be localized in large airways, and the use of large particles is more appropriate for cat allergen BCTs.
我们的目的是根据液滴粒径比较间歇性哮喘且对猫过敏（19名受试者）个体对主要猫过敏原（猫源Fel d 1）的支气管反应。我们使用了三种雾化器，其产生的颗粒质量中位空气动力学直径分别为1.4、4.8和10.3微米。使用了剂量计雾化器。将猫过敏原稀释，以使每个雾化器每次喷雾中的Fel d 1含量相同。每位患者接受三次乙酰甲胆碱支气管激发试验（BCT），每次试验24小时后进行一次猫过敏原BCT，每次试验使用不同的雾化器（每次随机选择，患者和测试者均始终不知情）。在三次猫过敏原BCT中的任何一次之前，受试者在乙酰甲胆碱反应性、第一秒用力呼气容积（FEV1）、用力肺活量（FVC）中间一半的平均用力呼气流量（FEF25 - 75）、呼气峰值流速（PEF）或呼吸困难（Borg量表）方面无差异。使用1.4微米雾化器时，猫过敏原的PD20为271纳克Fel d 1，使用4.8微米雾化器时为46纳克，使用10.3微米雾化器时为13.5纳克（p = 0.00001）。激发后24小时，吸入小颗粒（1.4微米）导致的FEF25 - 75显著低于大颗粒。总之，即刻支气管反应似乎局限于大气道，并且使用大颗粒更适合进行猫过敏原BCT。
