The similarities between the clinical characteristics of instractable asthma and attacks of late asthmatic response (LAR) have been noted. To clarify the pathogenesis of intractable asthma, the mechanism of LAR was studied using a technique of immuno-scaning electron microscopy to determine the density and distribution of immunoglobulins bound to the surface of peripheral blood basophils from bronchial asthma patients with asthmatic responses provoked by inhalation of house dust or Candida antigens. In a study of immunoglobulin density, the ratio of the number of IgG to IgE antibodies was higher in asthmatics with house dust-provoked LAR than in those with IAR, and the values were even higher in those with Candida-provoked LAR. In a study of the distribution of bound immunoglobulins, the overall rates of cap and patch formations, which seems to indicate an activation of cells, tended to be higher in asthmatics with house dust-provoked LAR than in those with IAR. The same tendency was also seen in those with Candida-provoked LAR. These results suggest that the IgG antibodies play an important role in LAR, although IgE antibodies are predominant in IAR. This trend is marked in asthmatics with Candida-induced LAR.
Adverse side effects of steroid therapy were investigated in 32 asthmatic patients. Thirty-two patients were classified into three groups according to steroid therapy for the past five years; group 1 has been treated with continuous steroid therapy, group 2 with occasional steroid therapy and group 3 without steroid therapy. The results were as follows. 1. Group 1 showed a low level of serum cortisol at 8-9 a. m. The serum concentration of cortisol in patients with daily steroid regimen was lower as compared to that in patients with alternateday steroid therapy. 2. The daily profile of serum cortisol was low in the steroid dependent asthmatic patients, and little increase of serum cortisol level after the administration of prednisolone was shown in group 1. 3. Serum IgG and IgM levels were significantly low in steroid dependent asthmatic patients. 4. The level of serum potassium was low in group 1.
The eosinophil is a well-known leukocyte acting as an effector cell in the allergic reaction mechanism. The application of appropriate materials has led to more exact results from allergic examinations. In an effort to further improve analysis, we established a novel purification method for eosinophils using the flow cytometry (PCM) of peripheral blood and bronchoalveolar lavage fluid (BALF) leucocytes from healthy and allergic subjects. We examined the function of these cells in chemotaxis by platelet activating factor (PAF) and recombinant human (rh) IL-5. We obtained following results. First, we were able to separate human eosinophils containing autofluorescence substance, which was detectable by FCM employing a 450 nm argon ion laser. Second, the purity and recovery rate of the eosinophils were 90.1 +/- 4.2% and 32.1 +/- 7.6% in the healthy subjects who had no peripheral eosinophilia (< 6%) and 93.7 +/- 4.4% and 37.2 +/- 7.5% in the allergic subjects who had eosinophila (> 6%). A relationship was readily apparent between the peripheral and purified eosinophil counts in the healthy subjects (r = 0.62). Autofluorescence of the eosinophil fraction on PCM was further found to be decreased in patients with marked eosinophilia because of an increase in hypodense eosinophils. Third, highly purified eosinophils (76%) were also obtained from the 6.5% eosinophils present in the bronchoalveolar lavage fluid of one bronchial asthma patient. Fourth, the maximal chemotaxis of these eosinophils was shown at 10(-6) M of platelet activating factor (PAF) and at 1 micrograms/ml of IL-5 in a dose-dependent manner. This activity in allergic patients was accelerated compared with that in healthy subjects.(ABSTRACT TRUNCATED AT 250 WORDS)
Eosinophils play an important role in the field of allergy, and release several kinds of granule proteins, leukotrien and superoxide. The most popular method to measure superoxide is utilizing SOD-inhibitable reduction of ferricytochrome c. And recently, the microplate reader enables us to measure superoxide generation from eosinophils more easily using this method. To measure superoxide, we must pay attention to obtain a high purity of eosinophils and not to damage cells. It is also possible to measure eosinophil peroxidase (EPO) using the microplate reader. We are measuring EPO with colorimetric assay using OPD (o-phenylenediamine). OPD is specific to EPO and has no cross reaction to myeloperoxidase. We, now have numerous methods to evaluate eosinophil function, so a selection must be made to select the most correct method.
Increasing amounts of data have shown that some Asian populations are more susceptible to increased weight and development of noncommunicable disease than Western populations. However, little is known about the association between increased weight, particularly within the normal range, and the development of asthma among Asian populations.To examine the association between increased body mass index (BMI) and asthma among Japanese adults, data from a nationwide population-based cross-sectional survey of asthma prevalence in Japan were analyzed (n = 22,962; age range 20-79 years). BMIs were classified into 7 categories considering WHO recommendations (cutoff points: 17.00, 18.50, 23.00, 25.00, 27.50 and 30.00), and the association between BMI and the prevalences of asthma as well as asthma symptoms were assessed by multivariate logistic regression.The prevalences of obesity (BMI ≥ 30.00) in this population were relatively low (males 3.0%, females 2.3%). BMI categories of 25.00 or higher in both genders were significantly associated with an increased risk of asthma compared with the reference category (BMI 18.50-22.99). Even in females with a BMI of 23.00-24.99, the prevalence of asthma significantly increased (adjusted odds ratio 1.49, 95% confidence interval 1.16-1.92) compared with that in the reference category.An increase in the prevalence of asthma among Japanese females starts at a BMI of 23.00, which was relatively lower than those reported from Western countries. This finding suggests that the Japanese population is likely to have asthma with a lesser degree of obesity than Western populations.
A 53-year-old woman was admitted for recurrent hemoptysis and cough. The chest radiograph showed an infiltrative shadow in the left upper region. Chest tomogram and CT scan showed a small calcification and consolidation in the left upper lobe. Fiberoptic bronchoscopy revealed fresh hemorrhage from the left upper bronchus but no broncholith or bleeding point were detected. Since the symptoms had disappeared by 10 days after admission, the patient was discharged and followed up as an outpatient. Three weeks later, she spontaneously expectorated a stone 3 mm in maximum diameter, with an irregular surface. Analysis revealed that the stone's composition was 56% of calcium phosphate and 44% of calcium carbonate. Hemoptysis seemed to have been caused by the broncholith, which had originated as a calcification of a peribronchial lymph node that subsequently eroded its way into the airway. After lithoptysis, no recurrence has been observed.
Several cross-sectional studies have suggested an association between obesity and asthma. However, few studies have investigated this relationship longitudinally, especially in middle-aged subjects. Although metabolic syndrome is a well-known risk factor for many non-communicable diseases, its contribution to asthma remains controversial.From 2008, specific health checkups for metabolic syndrome have been conducted throughout Japan. To seek relationships of obesity and metabolic syndrome with late-onset asthma in Japan, we analyzed data collected from health insurance claims and specific health checkups for metabolic syndrome at three large health insurance societies. Among subjects aged 40-64 years (n = 9888), multivariate logistic regression analyses were performed to investigate the relationships of obesity and metabolic syndrome in fiscal year 2012 (from April 2012 to March 2013) with the incidence of late-onset asthma in the following two years (from April 2013 to March 2015).In women, BMI 25-29.9 kg/m2 or ≥30 kg/m2, waist circumference ≥90 cm, and waist-to-height ratio ≥0.5 were shown to be significant risk factors for asthma, with adjusted odds ratios (95% CI) of 1.92 (1.35-2.75), 2.24 (1.23-4.09), 1.89 (1.30-2.75), and 1.53 (1.15-2.03), respectively. Significance was retained even after adjustment for metabolic syndrome, and there were no significant relationships between metabolic syndrome itself and the incidence of asthma in men or women.Only the obesity measures, not metabolic syndrome, were shown to be significant risk factors for the incidence of late-onset asthma but only in middle-aged Japanese women, and not in men.
