Bronchial response to the food ingestion challenge.

A total of 143 food ingestion challenges were carried out in 107 patients suffering from bronchial asthma of a perennial type. In the group of 21 patients with "positive or highly suggestive food history" related to their bronchial complaints, 21 food challenges were performed. In the group of 86 patients with "unknown food history," 122 ingestion challenges with foods causing a positive skin response were performed. Fifteen of the 21 patients with "positive food history" developed 15 (71%) bronchus-obstructive responses to foods ingested, while 45 of the 86 patients with "unknown food history" developed 68 (56%) bronchial responses to the food ingestion challenge. Twenty-three isolated immediate (within 2 hours), 11 isolated late (4 to 24 hours), 34 dual late (a combination of an immediate and a late), 6 isolated delayed (28 to 56 hours), and 9 dual delayed (a combination of an immediate and delayed) bronchus-obstructive responses were recorded. No significant correlation of the individual types of bronchial response to food ingested with other in vivo and in vitro diagnostic parameters were found. Although the exact pathogenetic and immunologic mechanisms underlying the particular types of bronchial response to foods are not yet fully clarified, the involvement of different types of hypersensitivity cannot be excluded. It could be concluded that the involvement of foods in bronchial asthma is more frequent than is usually expected. The diagnostic value of the food ingestion challenge seems to be superior to that of other diagnostic parameters. The definite confirmation of the role of a certain food, in patients with bronchial asthma, should therefore be provided by the food ingestion challenge demonstrating one of the clinical types of bronchus-obstructive response.