Sohei Makino

Clinical significance of bronchial sensitivity to acetylcholine and histamine in bronchial asthma

Abstract Acctylcholine or histamine inhalation tests were carried out on asthmatic patients. Sensitivity of the bronchi to inhaled acetylcholine or histamine was quantitatively presented as the respiratory threshold for acetylcholine or histamine, for example, the minimal amount of inhaled agent deposited in the lung which causes the initial decrease of FEV 1.0 greater than 10 per cent. Asthmatic symptoms, also, were presented as their scores. In bronchial asthma bronchial sensitivity to both acetylcholine and histamine varied widely, though it was remarkably greater than that in normal subjects. The respiratory thresholds were significantly correlated with the scores representing asthmatic symptoms for one year prior to tests or since the onset of asthma, and with the duration of asthma, but not with the scores representing symptoms for two weeks prior to tests. As far as relatively long periods of observation are concerned, bronchial sensitivity to chemical mediators is considered to be one of the main determining factors in producing asthmatic attacks, though it does not directly influence the individual variations of the symptoms within relatively short periods. Significant correlations between the respiratory thresholds and some of the lung functions suggest that asthmatic patients with advanced obstructive change in the lung tend to show bronchoconstriction by inhaled acetylcholine or histamine more readily.

α1-Antitrypsin Deficiency: A Variant with No Detectable α1-Antitrypsin

No α1-antitrypsin could be detected in the serum of a 24-year-old man with advanced pulmonary emphysema by agarose electrophoresis, immnuno-electrophoresis, double diffusion in agarose gel, or α1-antitrypsin genetic typing by a combination of starch-gel electrophoresis and crossed antigen-antibody electrophoresis. A circulating α1-antitrypsin inactivator could not be demonstrated. Evidence was obtained in family members of genetic transmission of this new α1-antitrypsin variant.

Bronchial reactivities to acetylcholine and IgE levels in asthmatic subjects after long-term remissions

Serum IgE concentrations, IgE antibody titers to mite allergen, the number ofblood cosinophils, the number of positive scratch tests, and the bronchial reactivity to acetylcholine were examined on the following 3 groups: (1) asthmatic subjects who had been in remission for 3 years or more; (2) asthmatics currently having asthma attacks; (3) normal healthy control subjects. Mean values were all higher in the asthmatic groups than in the controls. Differences between the 2 asthmatic groups were insignificant except for the acetylcholine inhalation tests, in which asthmatics in remission had lower bronchial reactivity than active asthmatics. In the former group, decreases in bronchial reactivity to acetylcholine after remission were observed in 7 of the 9 subjects. No correlation was obtained between bronchial reactivity and serum IgE. Of 7 asthmatics in remission having high serum IgE levels, 6 showed low bronchial responsiveness to acetylcholine, while the remaining one retained marked bronchial hyperreactivity. These results indicated that the atopic disposition of asthmatic subjects persisted but the bronchial reactivity to acetylcholine might decrease after long-term remission.

Clinical Studies on Bronchial Asthma by Component Analysis

Generally speaking, bronchial asthma is characterized by recurrent attacks of dyspnea and wheezing due to functional airway obstruction, often caused by allergy to inhaled allergens. Asthmatic symptoms are manifested by the intricate complex of many factors beside allergy, and most of them are closely interrelated. Consequently, when two factors of asthma are investigated, only one out of numerous facets of the complex of many factors can be observed.