Rosenberg G L, Rosenthal R R, Norman P S
J Allergy Clin Immunol. 1983 Mar;71(3):302-10. doi: 10.1016/0091-6749(83)90084-2.
We reexamined the ability of inhaled ragweed pollen to induce bronchoconstriction in ragweed-sensitive asthmatic patients using a turbo-inhaler to administer pollen quantitatively. Adult subjects were selected for study on the basis of fall season asthmatic attacks, positive skin test, histamine release, RAST, and bronchial challenge responses to ragweed extract. Not one of 12 such subjects had any bronchial response to oral inhalation of whole pollen grains even when the dose was increased to 7640 pollen grains (more than the estimated maximum daily exposure in season), whereas nasal challenge by the same method produced brisk hay fever responses without bronchospasm. On the other hand, when the pollen was ground to fragments with a size range of 1 to 8 micrometers, oral inhalation produced a 35% fall in airways conductance in six of seven subjects in doses ranging from 59 to 20,000 pollen grain equivalents. Atropine pretreatment did not modify the response to pollen fragments, making an irritant response unlikely. These data, coupled with earlier observations that no more than a few pollen grains penetrate further than the larynx, raise further questions about the role of whole ragweed pollen in fall asthma in allergic patients. In addition, ragweed-allergic asthmatics appear not to have their symptoms at the time of maximum pollen load in the air. We believe that small-particle allergens other than ragweed pollen should be considered in most cases of fall seasonal asthma.
我们使用涡轮吸入器定量给予花粉，重新研究了吸入豚草花粉在豚草敏感型哮喘患者中诱发支气管收缩的能力。根据秋季哮喘发作、皮肤试验阳性、组胺释放、放射变应原吸附试验（RAST）以及对豚草提取物的支气管激发反应，选择成年受试者进行研究。12名此类受试者中，即使将剂量增加到7640粒花粉（超过季节中估计的最大每日暴露量），也没有一人对口服吸入完整花粉粒有任何支气管反应，而通过相同方法进行鼻腔激发则产生了明显的花粉热反应且无支气管痉挛。另一方面，当花粉被研磨成大小在1至8微米范围内的碎片时，口服吸入在7名受试者中的6名中导致气道传导率下降35%，剂量范围为59至20000个花粉粒当量。阿托品预处理并未改变对花粉碎片的反应，这使得刺激性反应不太可能。这些数据，再加上早期观察到不超过少数花粉粒能穿透到喉部以上，进一步引发了关于完整豚草花粉在过敏性患者秋季哮喘中作用的疑问。此外，豚草过敏型哮喘患者似乎在空气中花粉负荷最大时并无症状。我们认为，在大多数秋季季节性哮喘病例中，应考虑除豚草花粉之外的小颗粒过敏原。
