Clinical and immunologic correlations of gastroduodenal lesions in patients with bronchial asthma

: To study local immunity of the stomach in bronchial asthma (BA) and the role of some immunity factors deficiency in development of gastroduodenal disturbances in BA patients, we have examined 271 male and female patients aged 18 to 60 years with exogenic and mixed BA of different severity. Gastroduodenal erosions were endoscopically diagnosed in 61 (22.5%) patients. We discovered that gastroduodenal pathology in BA develops in local deficiency of secretory IgA (sIgA) and high content of IgG and CIC in the gastric mucus. We registered a dose-dependent effect of long-term oral therapy with systemic glucocorticoids (SGC) in BA on gastroduodenal pathology and local immunity. Physiological doses reduce concentrations of IgG and CIC in gastric mucus and, by attenuation of immunocomplex reactions in gastric mucosa, decreased the rate of gastroduodenal erosions. Treatment with supraphysiological doses of SGC breaks specific defense of gastric mucosa and makes erosions more frequent. Thus, the above derangement of humoral immunity of the stomach in patients with non-hormone-dependent BA has common manifestations and direction with local immunity of the respiratory airways in BA suggesting involvement of "common immune system of the mucosas" in BA.