Girard J P, Gumowski P
Schweiz Med Wochenschr. 1984 Jun 23;114(25):890-2.
Known for many years, the relationship between bronchial asthma and bacteria are complex. Nevertheless they certainly are part of the several pathogenetic mechanisms of that disease. The recent discovery of specific IgE antibodies to several species of bacteria introduces new insights in the classification of these mechanisms. A careful consideration of the clinical symptoms remains a priority in analyzing the part played by bacteria in inducing bronchospasms. However, some laboratory procedures and especially the bronchial provocation tests with the specific antigen are of importance, bringing elements in accord with the immediate, late or delayed reaction. It is a basic requirement to have all these informations available to decide whether an hyposensitization therapy with bacterial extract is really needed. This will be done only in case of immediate type of reactions likely to be IgE mediated. Non specific polyvalent immunotherapy with a mixture of bacterial extract or derivates is sometimes indicated in cases of chronic infections of the upper and lower respiratory tract. Finally, some patients are reacting with an acute bronchospasm to minute doses of endotoxins. Therapy with bacterial extracts should be avoided in those patients.
支气管哮喘与细菌之间的关系已为人所知多年，其关系复杂。然而，它们无疑是该疾病多种发病机制的一部分。最近发现了针对几种细菌的特异性IgE抗体，为这些机制的分类带来了新的见解。在分析细菌在诱发支气管痉挛中所起的作用时，仔细考虑临床症状仍然是首要任务。然而，一些实验室检查，尤其是使用特异性抗原的支气管激发试验很重要，能提供与速发、迟发或延迟反应相符的依据。获取所有这些信息是决定是否真的需要用细菌提取物进行脱敏治疗的基本要求。只有在可能由IgE介导的速发型反应的情况下才会这样做。在上、下呼吸道慢性感染的病例中，有时会采用细菌提取物或衍生物的非特异性多价免疫疗法。最后，一些患者对微量内毒素会产生急性支气管痉挛反应。这些患者应避免使用细菌提取物进行治疗。
