Cavigioli G, Mastropasqua B, Pelucchi A, Marazzini L, Foresi A
Servizio di Broncopneumologia e Fisiopatologia Respiratoria G. Campari, Ospedale Citta di Sesto S. Giovanni, Milan, Italy.
Ann Allergy. 1993 May;70(5):411-7.
We studied the reproducibility of early (EAR) and late (LAR) asthmatic response to allergen challenge in 13 asthmatic children (four girls, age range: 10 to 17 years) sensitized only to Dermatophagoides pteronyssinus (Dp). Further, changes in bronchial responsiveness to inhaled methacholine following LAR were examined by measuring PC20FEV1 methacholine after 24, 48, and 72 hours. We carried out two carefully controlled allergen challenges with the same allergen dose within 4 to 6 weeks, at least 3 weeks apart, in each subject. On each study day, a bronchial challenge with methacholine was performed before and at different intervals after LAR. We found that EAR (maximal % fall in FEV1 within the 1st hour) measured on two different days was highly reproducible (37.8% +/- 8.9 and 38.7% +/- 12.1; CR: 12.1; Ri: 0.92; CoV: 15.1). Late asthmatic response (maximal % fall in FEV1 between 2nd and 12th hour) was also highly reproducible (47.5% +/- 12.4 and 46.1% +/- 13.4; CR: 10.1; Ri: 0.96; CoV: 10.1). All patients showed increases in nonspecific bronchial responsiveness to methacholine after LAR. Geometric mean PC20 M measured before the two allergen challenges was 0.609 mg/mL and 0.620 mg/mL, respectively. These values significantly decreased 24, 48, and 72 hours after LAR (after 1st allergen challenge: 0.086, 0.116, and 0.295 mg/mL; after 2nd allergen challenge: 0.075, 0.141, and 0.263 mg/mL). Ratio changes in PC20 methacholine (pre-allergen PC20 methacholine/lowest postallergen PC20) were highly reproducible (Ri: 0.95). We concluded that bronchial response to allergen challenge and the associated increase in responsiveness to methacholine are highly reproducible in well selected asthmatic subjects.(ABSTRACT TRUNCATED AT 250 WORDS)
我们研究了13名仅对尘螨（Dp）致敏的哮喘儿童（4名女孩，年龄范围：10至17岁）对过敏原激发的早期（EAR）和晚期（LAR）哮喘反应的可重复性。此外，通过在24、48和72小时后测量乙酰甲胆碱的PC20FEV1，检查了LAR后支气管对吸入乙酰甲胆碱反应性的变化。我们在4至6周内，对每个受试者进行了两次精心控制的相同过敏原剂量激发，间隔至少3周。在每个研究日，在LAR之前和之后的不同时间间隔进行乙酰甲胆碱支气管激发。我们发现，在两个不同日期测量的EAR（第1小时内FEV1的最大下降百分比）具有高度可重复性（37.8%±8.9和38.7%±12.1；CR：12.1；Ri：0.92；CoV：15.1）。晚期哮喘反应（第2至12小时内FEV1的最大下降百分比）也具有高度可重复性（47.5%±12.4和46.1%±13.4；CR：10.1；Ri：0.96；CoV：10.1）。所有患者在LAR后对乙酰甲胆碱的非特异性支气管反应性均增加。两次过敏原激发前测量的几何平均PC20 M分别为0.609 mg/mL和0.620 mg/mL。这些值在LAR后24、48和72小时显著下降（第一次过敏原激发后：0.086、0.116和0.295 mg/mL；第二次过敏原激发后：0.075、0.141和0.263 mg/mL）。乙酰甲胆碱PC20的比值变化（过敏原前PC20乙酰甲胆碱/最低过敏原后PC20）具有高度可重复性（Ri：0.95）。我们得出结论，在精心挑选的哮喘受试者中，支气管对过敏原激发的反应以及对乙酰甲胆碱反应性的相关增加具有高度可重复性。（摘要截短至250字）
