1
|
Olaguibel A, Oleaga M, Iraola A, Cortaberría R, Corcuera A, Alvarez-Puebla MJ, Tabar A, Ruete L, Botas A, Olaguibel JM. Exhaled Nitric Oxide (eNO) Measurements With the New evernoa Device Are Valid and Reproducible Through an Extended Range of eNO Levels. J Investig Allergol Clin Immunol 2021; 30:147-149. [PMID: 32327404 DOI: 10.18176/jiaci.0465] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- A Olaguibel
- NavarraBioMed, Gobierno de Navarra, Navarra, Spain
| | - M Oleaga
- NavarraBioMed, Gobierno de Navarra, Navarra, Spain
| | - A Iraola
- NavarraBioMed, Gobierno de Navarra, Navarra, Spain.,Unidad de Asma Grave, Servicio de Alergología, Complejo Hospitalario de Navarra, Navarra, Spain
| | - R Cortaberría
- NavarraBioMed, Gobierno de Navarra, Navarra, Spain.,Unidad de Asma Grave, Servicio de Alergología, Complejo Hospitalario de Navarra, Navarra, Spain
| | - A Corcuera
- Unidad de Asma Grave, Servicio de Alergología, Complejo Hospitalario de Navarra, Navarra, Spain
| | - M J Alvarez-Puebla
- NavarraBioMed, Gobierno de Navarra, Navarra, Spain.,Unidad de Asma Grave, Servicio de Alergología, Complejo Hospitalario de Navarra, Navarra, Spain.,CIBER Respiratorio
| | - A Tabar
- NavarraBioMed, Gobierno de Navarra, Navarra, Spain.,Unidad de Asma Grave, Servicio de Alergología, Complejo Hospitalario de Navarra, Navarra, Spain
| | - L Ruete
- Eversens, Pamplona, Navarra, Spain
| | - A Botas
- Eversens, Pamplona, Navarra, Spain
| | - J M Olaguibel
- NavarraBioMed, Gobierno de Navarra, Navarra, Spain.,Unidad de Asma Grave, Servicio de Alergología, Complejo Hospitalario de Navarra, Navarra, Spain.,CIBER Respiratorio
| |
Collapse
|
2
|
Alvarez-Puebla MJ, Arroabarren E, Zavala MJ, Corcuera A, Olaguibel A, Olaguibel JM. Responses to Biological Therapy in Severe Eosinophilic Asthma. J Investig Allergol Clin Immunol 2019; 29:335-337. [PMID: 30990776 DOI: 10.18176/jiaci.0403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- M J Alvarez-Puebla
- Unidad de Asma Grave, Complejo Hospitalario de Navarra, Pamplona, Spain.,Servicio de Alergología, Complejo Hospitalario de Navarra, Pamplona, Spain.,NavarraBioMed, Gobierno de Navarra, Pamplona, Spain.,CIBER Respiratorio
| | - E Arroabarren
- Servicio de Alergología, Complejo Hospitalario de Navarra, Pamplona, Spain
| | - M J Zavala
- Servicio de Alergología, Complejo Hospitalario de Navarra, Pamplona, Spain
| | - A Corcuera
- Servicio de Alergología, Complejo Hospitalario de Navarra, Pamplona, Spain.,NavarraBioMed, Gobierno de Navarra, Pamplona, Spain
| | - A Olaguibel
- NavarraBioMed, Gobierno de Navarra, Pamplona, Spain
| | - J M Olaguibel
- Unidad de Asma Grave, Complejo Hospitalario de Navarra, Pamplona, Spain.,Servicio de Alergología, Complejo Hospitalario de Navarra, Pamplona, Spain.,NavarraBioMed, Gobierno de Navarra, Pamplona, Spain.,CIBER Respiratorio
| |
Collapse
|
3
|
Arroabarren E, Alvarez-García J, Anda M, de Prada M, Ponce C, Alvarez-Puebla MJ. Impact of Specific Training in Anaphylaxis for Triage Nursing Staff in the Pediatric Emergency Department of a Tertiary Hospital. J Investig Allergol Clin Immunol 2018; 28:401-406. [DOI: 10.18176/jiaci.0271] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
|
4
|
Garcia-Rio F, Alvarez-Puebla MJ, Esteban-Gorgojo I, Barranco P, Olaguibel JM. Obesity and Asthma: Key Clinical Questions. J Investig Allergol Clin Immunol 2018; 29:262-271. [PMID: 30222113 DOI: 10.18176/jiaci.0316] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Obesity is a common comorbidity of asthma that is associated not only with development of the disease, but also with poorer disease control and greater severity. Recent prospective evidence supports the idea that body weight gain precedes the development of asthma, although the debate is far from over. The objective of this document is to conduct a systematic review of 3 clinical questions related to asthma and obesity: (a) Obesity and asthma: the chicken or the egg? Clinical insights from epidemiological and phenotyping studies. (b) Is obesity a confounding factor in the diagnosis and management of asthma, especially in severe or difficult-to-control asthma? (c) How do obese asthma patients respond to pharmacological treatments and to biological drugs? Do we have effective specific interventions? Revised epidemiological, pathological, and mechanistic evidence combined with data from interventional clinical trials prevent us from clearly stating that obesity causes asthma. However, the complexity and heterogeneity of both illnesses make several clinical scenarios possible. Furthermore, asthma represents an additional clinical challenge in the obese patient. Physicians need to be aware of the confounding effects created by the more marked perception of symptoms, alterations in lung function, and the various comorbidities that obese persons present. Exhaustive phenotyping of the obese asthma patient should enable us to develop a rational therapeutic plan, including both the pharmacological approach and specific antiobesity therapies such as combining diet and exercise and, in extreme cases, bariatric surgery.
Collapse
Affiliation(s)
- F Garcia-Rio
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES).,Servicio de Neumología, Hospital Universitario La Paz-IdiPAZ, Madrid, Spain.,Facultad de Medicina, Universidad Autónoma de Madrid, Madrid, Spain
| | - M J Alvarez-Puebla
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES).,Unidad de Asma Grave, Servicio de Alergia, Complejo Hospitalario de Navarra, Pamplona, Spain
| | | | - P Barranco
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES).,Servicio de Alergia, Unidad de Asma Grave, Hospital Universitario La Paz-IdiPAZ, Madrid, Spain
| | - J M Olaguibel
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES).,Unidad de Asma Grave, Servicio de Alergia, Complejo Hospitalario de Navarra, Pamplona, Spain
| |
Collapse
|
5
|
Abstract
Eosinophilic asthma phenotype predicts good response to corticosteroids and associates to asthmatic exacerbations. Sputum induction by hypertonic saline (HS) inhalation is technically demanding. Bronchial hyperresponsiveness (BHR) to osmotic agents indirectly mirrors active airway inflammation. We compared the safety and ability of HS and mannitol to induce sputum and measure BHR. We evaluated the stability of inflammatory phenotypes. We studied 35 non-smoking asthmatics randomized to undergo HS and mannitol challenges on 2 days 1 week apart. Sputum was sampled for cell analysis and phenotyped as eosinophilic (≥3% eosinophils) and non-eosinophilic (<3%) asthma. Nineteen subjects had BHR to mannitol and nine of them also had BHR to HS. Drops in forced expiratory volume in 1 s were higher from HS challenge than from mannitol challenge. Adequate sputum samples were obtained from 80% subjects (68% mannitol and 71% HS). Eosinophils and macrophages from both challenges correlated. Neutrophils were higher in sputum from HS. Ninety percent samples were equally phenotyped with HS and mannitol. Fractional exhaled nitric oxide, sputum eosinophils and BHR correlated in both challenges. HS and mannitol showed similar capacity to produce valuable sputum samples. BHR to both osmotic stimuli partially resembled airway eosinophilic inflammation but mannitol was more sensitive than HS to assess BHR. Eosinophilic phenotype remained stable in most patients with both stimuli.
Collapse
Affiliation(s)
- MJ Alvarez-Puebla
- Departamento de Alergología, NavarraBiomed, Complejo Hospitalario de Navarra, Pamplona, Spain
- CIBERES, Complejo Hospitalario de Navarra, Pamplona, Spain
| | - JM Olaguibel
- Departamento de Alergología, NavarraBiomed, Complejo Hospitalario de Navarra, Pamplona, Spain
- CIBERES, Complejo Hospitalario de Navarra, Pamplona, Spain
| | - E Almudevar
- Departamento de Anatomía Patológica, NavarraBiomed, Complejo Hospitalario de Navarra, Pamplona, Spain
| | - AA Echegoyen
- Departamento de Anatomía Patológica, NavarraBiomed, Complejo Hospitalario de Navarra, Pamplona, Spain
| | - C Vela
- Departamento de Alergología, NavarraBiomed, Complejo Hospitalario de Navarra, Pamplona, Spain
| | - B de Esteban
- Departamento de Alergología, NavarraBiomed, Complejo Hospitalario de Navarra, Pamplona, Spain
| |
Collapse
|
6
|
Alvarez-Puebla MJ, Olaguibel Rivera JM, Almudevar E, Echegoyen AA, de Esteban Chocarro B, Cambra K. Cutoff point for exhaled nitric oxide corresponding to 3% sputum eosinophils. J Investig Allergol Clin Immunol 2015; 25:107-111. [PMID: 25997303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023] Open
Abstract
BACKGROUND The eosinophilic asthma phenotype (sputum eosinophils 3%) indicates a good response to corticosteroids and T(H)2 immunomodulators. Exhaled nitric oxide (FeNO) is rapidly measured by portable devices, and although it is not a selective marker of eosinophilic inflammation, several studies have demonstrated a strong correlation with it. We investigated which FeNO value was the best fit with 3% sputum eosinophils in asthma patients. METHODS We included 129 consecutive, nonsmoking asthmatics who underwent skin tests, FeNO quantification (NIOX MINO), spirometry, and induced sputum analysis and completed the Asthma Control Test questionnaire. Receiver operating characteristic curves were constructed, and logistic regression analysis was performed. RESULTS Symptoms were detected more frequently in the eosinophilic asthma group, as were higher airway obstruction and sensitivity to hypertonic saline. The FeNO cutoff point of 21 ppb was the best fit with 3% sputum eosinophilia. This value behaved better among corticosteroid-naïve patients (sensitivity, 97%; specificity, 58%; positive predictive value, 86%; negative predictive value, 88%) than among those receiving corticosteroids (sensitivity, 81%; specificity, 25%; positive predictive value, 74%; negative predictive value, 33%). CONCLUSION FeNO ≥ 21 ppb is associated with airway eosinophilia. In corticosteroid-naïve patients, FeNO < 21 ppb enables us to rule out airway eosinophilia.
Collapse
|
7
|
Alvarez-Puebla MJ, Indurain S, Giner A, Nuin M, Sexmilo J, Tabar AI. Online medical consultations applied to allergy. J Investig Allergol Clin Immunol 2014; 24:125-127. [PMID: 24834777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023] Open
|
8
|
Olaguibel Rivera JM, Alvarez-Puebla MJ, Puy Uribe San Martín M, Tallens Armand ML. Duration of asthma and lung function in life-long nonsmoking adults. J Investig Allergol Clin Immunol 2007; 17:236-41. [PMID: 17694695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2023] Open
Abstract
BACKGROUND The airways of adult or elderly asthmatics are likely candidates for airway remodeling, resulting in persistent airflow obstruction. This population can provide a good model for cross-sectional evaluation of the effect of asthma duration on airflow. METHODS We evaluated postbronchodilator airflow and lung volumes at baseline and after a short course of oral prednisone in a group of 42 never-smokers with persistent mild or moderate asthma aged 55 years or older. Patients were grouped as having short duration asthma (SDA, <14 years) or long duration asthma (LDA, > or =14 years) according to the median duration of the disease (14 years) of the sample. RESULTS There were no significant differences in patient characteristics or asthma severity indices between the groups. After a short course of prednisone, forced expiratory volume in 1 second (FEV1) and the ratio of FEV to forced vital capacity (FVC) were significantly higher for the SDA group. Only 3 patients presented persistent airflow limitation (FEV1/FVC% < 75%). An inverse correlation was demonstrated between duration of asthma and postbronchodilator FEV1 (% predicted) (r = -0.43, P = .01) and FEV1/FVC% (r = -0.50, P = .003). CONCLUSION Our data show a close relationship between duration of disease and loss of lung function, supporting the concept of asthma as a slow, progressive disease at least among those patients with a mild-to-moderate severity. Permanent airflow obstruction in mild or moderate asthma is unusual, but can occur in a small number suffering from the disease for years.
Collapse
Affiliation(s)
- J M Olaguibel Rivera
- Allergology Section, Lung Function Laboratory, Hospital Virgen del Camino, Pamplona, Spain.
| | | | | | | |
Collapse
|
9
|
Olaguíbel JM, Alvarez-Puebla MJ, Anda M, Gómez B, García BE, Tabar AI, Arroabarren E. Comparative analysis of the bronchodilator response measured by impulse oscillometry (IOS), spirometry and body plethysmography in asthmatic children. J Investig Allergol Clin Immunol 2005; 15:102-6. [PMID: 16047709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/03/2023] Open
Abstract
BACKGROUND Asthma is common among young children. The assessment of respiratory resistance by the impulse oscillometry system (IOS), based on the superimposition of respiratory flow by short-time impulses, requires no patient active collaboration. AIM We evaluated the baseline repeatability and bronchodilator response of IOS indices in preschool children, their correlation with spirometry and whole body plethysmography, and differences between atopic and nonatopic children. PATIENTS AND METHODS Thirty-three asthmatic children (3-6 yrs.) underwent IOS measurement (R5rs, R20rs and X5rs) by triplicate at the baseline, after placebo and after salbutamol inhalation. Spirometry (FEV1) and whole body plethysmography (sRaw) were made at the baseline and after salbutamol. Baseline within-test (coefficient of variation: CV%) and between-test repeatability (baseline-placebo) were addressed. Bronchodilator response was evaluated by the SD index (change in multiples of the between-test repeatability). RESULTS Baseline repeatability for R5rs was 4.1%. Its values decreased by 2SD after salbutamol inhalation, and correlated with FEV1 and sRaw at both, baseline (r=-0.51 and r=0.49) and post-salbutamol (r=-0.63 and r=0.54). A trend towards correlation between salbutamol-induced changes in R5rs and in sRaw (r=0.33) was observed. Atopic and non-atopic children showed no differences in lung function. CONCLUSION IOS was well accepted by young asthmatic children and provided reproducible and sensitive indices of lung function. Resistance values obtained by IOS at low frequency (R5rs) were reproducible and correlated with spirometry and plethysmographic values.
Collapse
Affiliation(s)
- J M Olaguíbel
- Servicio de Alergologia. Hospital Virgen del Camino. Pamplona. Spain.
| | | | | | | | | | | | | |
Collapse
|
10
|
Tabar AI, Alvarez-Puebla MJ, Gomez B, Sanchez-Monge R, García BE, Echechipia S, Olaguibel JM, Salcedo G. Diversity of asparagus allergy: clinical and immunological features. Clin Exp Allergy 2004; 34:131-6. [PMID: 14720273 DOI: 10.1111/j.1365-2222.2004.01856.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Asparagus (Asparagus officinalis) is an extensively grown and consumed vegetable. To a lesser extent than other Liliaceae vegetables, allergic contact dermatitis (ACD) due to asparagus has been reported. However, only a few case reports of asparagus IgE-mediated allergy have been published. In a previous study, we demonstrated that two lipid transfer proteins (LTPs) (Aspa o 1.01 and Aspa o 1.02) were relevant allergens of asparagus. OBJECTIVE We retrospectively analysed the 27 patients diagnosed with asparagus allergy during the last 5 years. All of them reported adverse symptoms after either asparagus ingestion or handling. We describe their clinical features and evaluate whether they were associated to immunological findings (immunoblot pattern and skin reactivity to LTPs). METHODS Patients underwent skin prick and patch tests with standard panels of vegetables and aeroallergens. Besides crude asparagus extract, two purified LTPs were prick and patch tested. Total and specific IgE measurements and asparagus extract IgE immunoblotting were performed. Patients reporting asthma symptoms underwent specific inhalation challenge to asparagus. RESULTS Of the 27 subjects, eight had ACD, 17 had IgE-mediated allergy and two had both ACD- and IgE-mediated allergy. Positive patch tests with the crude asparagus extract but not with LTPs were observed in subjects with ACD (n=10). Of 19 patients with IgE-mediated disease, 10 had contact urticaria after asparagus handling. Of them, five subjects and five others without skin allergy showed respiratory symptoms; of them, eight were diagnosed with occupational asthma confirmed by positive asparagus inhalation challenge, whereas the remaining two had isolated rhinitis. Four patients suffered from immediate allergic reactions related to asparagus ingestion (food allergy); three of them reported anaphylaxis whereas the other had oral allergic syndrome. Positive IgE immunoblotting (bands of 15 and 45-70 kDa) was observed in 10 subjects. Of 10 subjects with positive prick test to LTPs, six showed bands at 15 kDa. Either IgE-binding bands or positive prick tests to LTPs were observed in asthma (62%) and anaphylaxis (67%). CONCLUSION Asparagus is a relevant source of occupational allergy inducing ACD and also IgE-mediated reactions. Severe disease (anaphylaxis or asthma) is common and LTPs seem to play a major role. The clinical relevance of LTP sensitization among patients with mild disease or symptom-free subjects should be addressed in prospective studies.
Collapse
Affiliation(s)
- A I Tabar
- Servicio de Alergología, Hospital Virgen del Camino, Pamplona, Spain and Unidad de Bioquímica, Dept. Biotecnología, ETS Ingenieros Agrónomos, Ciudad Universitaria, Madrid, Spain.
| | | | | | | | | | | | | | | |
Collapse
|
11
|
Alvarez-Puebla MJ, García-Figueroa BE, Tabar-Purroy AI, Olaguibel-Rivera JM. Discriminant analysis in allergic rhinitis and asthma: methacholine dose-response slope allows a good differentiation between mild asthma and rhinitis. Respir Med 2003; 97:30-6. [PMID: 12556008 DOI: 10.1053/rmed.2002.1420] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Asthma and rhinitis frequently coexist in allergic patients, but nasal symptoms may predominate, leading to asthma underdiagnosis and undertreatment. Discriminant analysis obtains the best differentiation between groups using one or one set of variables. Our aim was to identify the laboratory test [allergen exposure, total and specific serum IgE, lung function, blood eosinophils and, bronchial response and sensitivity to methacholine (Mth) and allergen] or combination of them that allowed the best differentiation between mild asthma and allergic rhinitis. A cross-sectional analysis was performed in 86 Dermatophogoides pteronyssinus allergic rhinitis patients, who were classified according to clinical data as rhinitis plus mild asthma (n = 62) or "pure" rhinitis (n = 24). Bronchial symptoms had been exhaustively evaluated during a 2-years pre-inclusion period. Patients underwent skin tests and bronchial challenge with Mth and allergen. The exposure to D. pteronyssinus allergen (Der pl) was quantified in dust samples. Dose-response curves with Mth [until the FEV1 fell by 40% or the maximal dose (200 mg/ml) was inhaled] were attained. We developed multiple models of discriminant analysis in order to evaluate the capacity of the above variables to differentiate groups. Asthma patients had higher total and specific IgE levels and a greater sensitivity (PD20 values) and response [dose-response slope (DRS)] to both Mth and allergen. The model entering these variables was the one that correctly classified more patients (79.2%). The discriminative power of the model that only included Mth-DRS values was similar to the above (78.8%). Bronchial response to Mth is quantitatively different in allergic rhinitis patients who display mild asthma symptoms when compared to those that only report rhinitis, suggesting a distinct bronchial intrinsic behavior. The utilization of complete dose-response curves with Mth allows a good separation between mild asthma and "pure" rhinitis patients and might be useful in the diagnosis of mild asthma. Whether the early detection and treatment of these patients prevents the development of symptomatic asthma needs further evaluation.
Collapse
|
12
|
Alvarez-Puebla MJ, Olaguibel-Rivera JM, Urbiola-Marcilla E, Garcia BE, Tabar-Purroy AI. Determinants of allergen-induced late bronchial responses in mild asthmatics. Chest 2001; 119:120-7. [PMID: 11157593 DOI: 10.1378/chest.119.1.120] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
STUDY OBJECTIVE To examine the baseline factors influencing the occurrence and magnitude of immediate- and late-phase responses in asthmatic patients after an allergen-induced bronchial provocation test (A-BPT). DESIGN Cross-sectional analysis in a homogenous group of 31 mild, Dermatophagoides pteronyssinus-allergic patients with asthma. SETTING Allergy Department, Hospital Virgen del Camino, Pamplona, Spain. INTERVENTIONS AND MEASUREMENTS Patients completed an asthma symptom questionnaire and underwent skin tests, sputum induction, and methacholine bronchial provocation test. The A-BPT was performed on a separate day. Sputum cell profile and eosinophil cationic protein (ECP), tryptase, albumin, and interleukin-5 levels were quantified in the entire sputum supernatant. Assays were done for eosinophils in blood, and/or ECP, and total and specific IgE levels in serum. Exposure to D pteronyssinus major allergens (Der p1 and Der 2) was measured by an assay based on monoclonal antibodies. RESULTS A-BPT findings were positive in all patients, and late-phase responses were detected in 29%. Late responders were exposed to higher levels of Der p1 (p = 0.028), had greater levels of ECP (p = 0.007) and albumin (p = 0.019) in sputum, and showed a trend toward higher lymphocyte numbers (p = 0.053) in sputum than isolated early responders. The allergen-induced provocative dose that induced a fall in FEV(1) values > or =20% from the postdiluent values correlated with bronchial hyperresponsiveness (r = 0.36). The late-phase response magnitude correlated with Der p1 exposure (r = 0.49) and showed a trend toward correlation with sputum ECP levels (r = 0.38). CONCLUSION Factors involved in the development of allergen-induced immediate- and late-phase responses are different. Allergen natural exposure might prime the infiltration of the airway by activated inflammatory cells enhancing the appearance and the severity of late-phase responses.
Collapse
|