[Clinico-immunological and bronchological characteristics of the late onset asthma]

Clinicoimmunological and bronchological examination was performed in 452 patients with bronchial asthma (BA) which were divided into two groups: 286 patients with late BA (onset at the age of 40 and older) and 166 patients with BA onset at the age under 40. Late BA develops because of non-allergic factors, especially persistent bronchopulmonary infection. Bad pulmonary background contributes to development of rapidly progressing respiratory obstruction with irreversible component. Cytological tests of the bronchoalveolar lavage revealed subnormal cytosis and viability of the cells, high counts of eosinophils and neutrophils, cells of bronchial epithelium with signs of dystrophy, low count of alveolar macrophages. Immunological tests in late BA patients evidence for suppression of local bronchopulmonary defense, low levels of both T-helper and T-suppressor cells, deficiency of C3 and C4, high serum IgG. The above changes are determined for the most part by immunosuppression induced by concomitant and past respiratory diseases.