Wanner A, Russi E, Brodnan J M, Danta I, Gazeroglu H
J Allergy Clin Immunol. 1985 Aug;76(2 Pt 1):177-81. doi: 10.1016/0091-6749(85)90698-0.
Some patients with allergic asthma exhibit late-phase responses to inhalation challenge with specific antigen. However, the duration of these responses is difficult to determine because of diurnal variations in airway function, a common phenomenon in patients with asthma. We therefore examined the pattern and duration of pulmonary function in six asymptomatic patients with a history of ragweed asthma and a documented late-phase response after specific and nonspecific bronchial challenge and compared them to responses after control challenge with normal saline. On 3 different days, specific airway conductance (SGaw) and gas distribution by the single breath nitrogen test were measured before (9:00 A.M.) and hourly for 24 hours after inhalation challenge with either normal saline, ragweed extract, or histamine at concentrations sufficient to decrease SGaw immediately by 35% or more. The fluctuations in SGaw after saline and histamine were considerable but failed to follow a typical diurnal or biphasic pattern. There was no difference in mean SGaw between the histamine and saline challenges from 1 to 24 hours after inhalation. In contrast, ragweed challenge produced a typical late-phase response followed by partial recovery of mean SGaw. However, mean SGaw remained subsequently lower than after saline challenge throughout the remaining observation period with fluctuations about this lower level. Gas distribution demonstrated marked intra- and intersubject variations and was therefore not different among the three challenges at any time of measurement. These observations suggest that a single specific but not nonspecific bronchial challenge causes prolonged airflow obstruction in subjects with allergic asthma that lasts 24 hours or longer, independent of variations in baseline airway function.
一些过敏性哮喘患者对特定抗原吸入激发试验会出现迟发相反应。然而，由于哮喘患者气道功能存在昼夜变化这一常见现象，这些反应的持续时间很难确定。因此，我们研究了6例有豚草哮喘病史且在特异性和非特异性支气管激发试验后有明确迟发相反应的无症状患者的肺功能模式和持续时间，并将其与生理盐水对照激发试验后的反应进行比较。在3个不同的日子里，分别于吸入激发试验前（上午9:00）以及用生理盐水、豚草提取物或组胺进行吸入激发试验后每小时测量一次特异性气道传导率（SGaw）和单次呼吸氮试验测定的气体分布，所用组胺浓度足以使SGaw立即降低35%或更多。生理盐水和组胺激发试验后SGaw的波动相当大，但未呈现典型的昼夜或双相模式。吸入后1至24小时，组胺激发试验和生理盐水激发试验的平均SGaw没有差异。相比之下，豚草激发试验产生了典型的迟发相反应，随后平均SGaw部分恢复。然而，在整个剩余观察期内，平均SGaw随后仍低于生理盐水激发试验后的水平，并围绕该较低水平波动。气体分布在受试者内和受试者间均表现出显著差异，因此在任何测量时间点，三种激发试验之间均无差异。这些观察结果表明，单次特异性而非非特异性支气管激发试验会导致过敏性哮喘患者出现持续24小时或更长时间的气流阻塞延长，且与基线气道功能的变化无关。
