Ward A J, McKenniff M G, Evans J M, Page C P, Costello J F
Department of Thoracic Medicine, King's College School of Medicine and Dentistry, London, U.K.
Respir Med. 1994 Jul;88(6):445-51. doi: 10.1016/s0954-6111(05)80048-4.
Increased bronchial responsiveness has been reported at various time points following allergen challenge (AC), and may be related to the magnitude of the late response (LAR). We have studied 20 mild asthmatics, who were known to develop a late asthmatic response to inhalation of house dust mite extract (fall of > 15% from post-diluent baseline FEV1 from 2 to 7h after AC). The provocation concentration of methacholine causing a 20% fall in FEV1 (PC20 FEV1) was measured before and 24 h after challenge with house dust mite extract (HDM). The mean (SEM) change in log(PC20) was 0.08 (0.09) mg ml-1, and was not significant (P = 0.38; paired t-test). The change in PC20 for each subject was not significantly correlated with the size of LAR (r = -0.33; P > 0.05), but was significantly correlated with the absolute change from baseline FEV1 at 24 h (r = 0.67; P < 0.01). Our subjects had a high baseline responsiveness, when compared with previous studies. We suggest they may have been approaching a maximally responsive state prior to study, and allergen challenge may have had little effect in further increasing responsiveness. Exposure to allergen in late responders is not necessarily followed by an increase in non-specific bronchial responsiveness.
据报道,在过敏原激发(AC)后的不同时间点,支气管反应性会增加,这可能与迟发反应(LAR)的程度有关。我们研究了20名轻度哮喘患者,已知他们吸入屋尘螨提取物后会出现迟发性哮喘反应(AC后2至7小时,FEV1较稀释后基线下降>15%)。在用屋尘螨提取物(HDM)激发前和激发后24小时,测量引起FEV1下降20%的乙酰甲胆碱激发浓度(PC20 FEV1)。log(PC20)的平均(SEM)变化为0.08(0.09)mg/ml,差异无统计学意义(P = 0.38;配对t检验)。每个受试者的PC20变化与LAR的大小无显著相关性(r = -0.33;P > 0.05),但与24小时时FEV1相对于基线的绝对变化显著相关(r = 0.67;P < 0.01)。与之前的研究相比,我们的受试者基线反应性较高。我们认为他们在研究前可能已接近最大反应状态,过敏原激发可能对进一步增加反应性影响不大。迟发反应者接触过敏原后,非特异性支气管反应性不一定会增加。