Freedman S O
Can Med Assoc J. 1976 Feb 21;114(4):346-8.
Major advances have recently been made in both the diagnosis and the treatment of allergic asthma. The radioallergosorbent test (RAST), which measures allergen specificity of lgE antibodies in vitro, offers as good results as direct skin tests for allergy, without the inconvenience, discomfort and risk for the patient of the latter. However, the RAST must be done in a radioisotope laboratory, and standardized extracts of test allergens are lacking. Several new drugs, administered by inhalation and relatively free from serious side effects, are highly effective in treating asthma. Disodium cromoglycate, believed to stabilize tissue mast cells, protects particularly against exercise- or antigen-induced bronchospasm, and often permits reduction or withdrawal of corticosteroid therapy. Some acetonides or esters of glucocorticoids, because of their greatly increased topical anti-inflammatory activity, are effective in doses too small to cause serious systemic side effects. With the most topically effective, beclomethasone dipropionate, systemic corticosteroid therapy can usually be reduced or withdrawn, but recovery of hypothalamic-pituitary-adrenal function may be delayed; the drug regimens should therefore overlap.
近年来，过敏性哮喘的诊断和治疗都取得了重大进展。放射性变应原吸附试验（RAST）可在体外测量IgE抗体的变应原特异性，其结果与直接皮肤过敏试验一样好，且不会给患者带来后者的不便、不适和风险。然而，RAST必须在放射性同位素实验室进行，而且缺乏标准化的试验变应原提取物。几种通过吸入给药且相对无严重副作用的新药，在治疗哮喘方面非常有效。色甘酸钠被认为可稳定组织肥大细胞，特别能预防运动或抗原诱发的支气管痉挛，且常可减少或停用皮质类固醇疗法。一些糖皮质激素的丙酮化物或酯类，由于其局部抗炎活性大大增强，以小剂量给药即可有效，不会引起严重的全身副作用。使用局部效果最佳的二丙酸倍氯米松时，通常可减少或停用全身皮质类固醇疗法，但下丘脑-垂体-肾上腺功能的恢复可能会延迟；因此药物治疗方案应有重叠期。
