Olson R, Karpink M H, Shelanski S, Atkins P C, Zweiman B
University of Pennsylvania School of Medicine, Philadelphia.
J Allergy Clin Immunol. 1990 Aug;86(2):153-9. doi: 10.1016/s0091-6749(05)80060-0.
Corticosteroids, used in low to moderate doses for short time intervals, do not suppress immediate percutaneous skin test responses to allergens, compound 48/80, or histamine. During routine skin testing, in our clinic, intradermal injection of codeine (1 mg/ml) and histamine (0.02 mg/ml) are used as positive controls. We had noted that responses to codeine but not histamine are decreased in some patients with asthma who had been receiving prolonged corticosteroid therapy. Therefore, we retrospectively compared skin test responses to codeine and histamine between 25 adult subjects with asthma receiving steroids (group I) and 25 age-matched control subjects (group II). In group I, the mean wheal diameters, induced by codeine but not histamine, were significantly less than diameters in group II. This decreased skin test reactivity to codeine was not due to effects of theophylline also taken by group I subjects, since the skin test reactions of other subjects with asthma, treated with theophylline but not steroids (group III), were not significantly different from reactions in group II. We conclude that prolonged courses of corticosteroids do not appear to alter histamine-induced vascular reactivity in skin but may affect cutaneous mast cell responses by an undefined mechanism.
短期使用低至中等剂量的皮质类固醇不会抑制对变应原、48/80复合物或组胺的即时经皮皮肤试验反应。在我们诊所进行常规皮肤试验期间，皮内注射可待因（1毫克/毫升）和组胺（0.02毫克/毫升）用作阳性对照。我们注意到，在一些接受长期皮质类固醇治疗的哮喘患者中，对可待因的反应降低，但对组胺的反应未降低。因此，我们回顾性比较了25名接受类固醇治疗的成年哮喘患者（第一组）和25名年龄匹配的对照受试者（第二组）对可待因和组胺的皮肤试验反应。在第一组中，由可待因而非组胺引起的平均风团直径明显小于第二组。这种对可待因的皮肤试验反应性降低并非第一组受试者同时服用的茶碱所致，因为其他接受茶碱但未接受类固醇治疗的哮喘患者（第三组）的皮肤试验反应与第二组无显著差异。我们得出结论，长期使用皮质类固醇似乎不会改变组胺诱导的皮肤血管反应性，但可能通过一种不明机制影响皮肤肥大细胞反应。
