James J M, Eigenmann P A, Eggleston P A, Sampson H A
Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Am J Respir Crit Care Med. 1996 Feb;153(2):597-603. doi: 10.1164/ajrccm.153.2.8564104.
To investigate the possible pathogenic role of food allergy in asthma, airway hyperresponsiveness was measured by methacholine inhalation challenges (MIC) performed before and after double-blind, placebo-controlled food challenges (DBPCFC) in 26 food-allergic, asthmatic patients. Airway hyperresponsiveness was classified as severe in two cases (PD20FEV1 < 2 breath units, BU), moderate in 18 (PD20FEV1: 2-20 BU), and mild in six (PD20FEV1 > 20 BU). Medications included albuterol (81%), inhaled steroids (38%), cromolyn (35%), and theophylline (23%). MICs were performed in the afternoon after DBPCFC. Of the 22 positive DBPCFC, 12 involved chest symptoms (cough, wheezing, or both). Another 10 positive DBPCFCs included laryngeal, gastrointestinal, and/or skin symptoms without any chest symptoms. Significant increases in airway hyperresponsiveness were evident in seven of 12 patients experiencing chest symptoms during DBPCFC. Significant increases in airway hyperresponsiveness were observed in one patient without chest symptoms during a positive DBPCFC and one patient after a negative DBPCFC. However, this last patient had a negative MIC with the same antigen 1 yr later. These studies indicate that food-induced allergic reactions can increase airway reactivity, and may do so without inducing acute asthma.
为了研究食物过敏在哮喘中可能的致病作用，对26例食物过敏的哮喘患者在双盲、安慰剂对照食物激发试验（DBPCFC）前后进行了乙酰甲胆碱吸入激发试验（MIC）以测定气道高反应性。气道高反应性分为重度2例（PD20FEV1<2呼吸单位，BU）、中度18例（PD20FEV1：2 - 20 BU）和轻度6例（PD20FEV1>20 BU）。所用药物包括沙丁胺醇（81%）、吸入性类固醇（38%）、色甘酸钠（35%）和茶碱（23%）。MIC在DBPCFC后的下午进行。在22例DBPCFC阳性患者中，12例出现胸部症状（咳嗽、喘息或两者皆有）。另外10例DBPCFC阳性患者包括喉部、胃肠道和/或皮肤症状但无任何胸部症状。在DBPCFC期间出现胸部症状的12例患者中有7例气道高反应性明显增加。在1例DBPCFC阳性但无胸部症状的患者以及1例DBPCFC阴性后的患者中观察到气道高反应性显著增加。然而，最后1例患者在1年后用相同抗原进行MIC时结果为阴性。这些研究表明食物诱导的过敏反应可增加气道反应性，且可能在不诱发急性哮喘的情况下发生。
