Katoh H, Majima T, Yamaguchi M
First Department of Internal Medicine, Nihon University School of Medicine.
Arerugi. 1991 Jun;40(6):587-96.
The occurrence of late asthmatic response (LAR) is effectively prevented by corticosteroids, but not all by beta-adrenergic drugs. LAR is considered to be of great clinical and therapeutic importance and to be involved in the progression of bronchial asthma into a severe or even an intractable form. However the exact mechanism of the occurrence of LAR remains obscure in many respects. LAR is believed to be due to type I allergy. In guinea pigs, a positive bronchial inhalation challenge following passive sensitization with allogeneic antibody does not induce LAR or eosinophilic infiltration of lung tissue. This experimental fact led us to surmise that LAR would seem likely to be elicited in passively sensitized animals if pronounced eosinophilic infiltration can be induced concurrently and to conduct an experiment with conjoined inhalation of platelet activating factor (PAF). PAF, which has a chemotactic activity for eosinophils, was administered to passively sensitized animals in attempt to examine a role of eosinophils in LAR. A goodly number of animals developed LAR on additional PAF inhalation. These animals, when compared with those without LAR, showed a significantly larger proportion of eosinophils in BALF (p less than 0.05) with an upward tendency for the proportion of neutrophils. Histologically, there was noted a striking association between LAR and eosinophilic infiltration of the bronchial submucosa. These results suggest that anti-IgE antibody is deeply involved in the elicitation of LAR, stressing the importance of eosinophilic infiltration.
皮质类固醇可有效预防迟发性哮喘反应（LAR）的发生，但β-肾上腺素能药物并非都能预防。LAR被认为具有重要的临床和治疗意义，并且与支气管哮喘发展为重度甚至难治性形式有关。然而，LAR发生的确切机制在许多方面仍不清楚。LAR被认为是由I型过敏引起的。在豚鼠中，用同种异体抗体被动致敏后进行的阳性支气管吸入激发试验不会诱导LAR或肺组织嗜酸性粒细胞浸润。这一实验事实使我们推测，如果能同时诱导明显的嗜酸性粒细胞浸润，被动致敏动物可能会引发LAR，并进行了联合吸入血小板活化因子（PAF）的实验。PAF对嗜酸性粒细胞具有趋化活性，将其给予被动致敏动物，试图研究嗜酸性粒细胞在LAR中的作用。大量动物在额外吸入PAF后出现LAR。与未出现LAR的动物相比，这些动物的支气管肺泡灌洗液（BALF）中嗜酸性粒细胞比例显著更高（p<0.05），中性粒细胞比例有上升趋势。组织学上，LAR与支气管黏膜下层嗜酸性粒细胞浸润之间存在显著关联。这些结果表明，抗IgE抗体与LAR的诱发密切相关，强调了嗜酸性粒细胞浸润的重要性。
