Mediator release after endobronchial antigen challenge in patients with respiratory allergy

The aim of the present study was to evaluate the release of some potential mediators of allergic reactions, such as histamine, peptide leukotrienes (LTs), LTB4 and prostaglandin D2 (PGD2), in bronchoalveolar lavage (BAL) fluids from 11 patients with respiratory allergy (eight with bronchial asthma and three with allergic rhinitis), who underwent specific endobronchial challenge. Histamine, peptide LT, and PGD2 levels in BAL fluids increased significantly after antigen stimulation both in patients with asthma and in patients with rhinitis. By contrast, LTB4 concentration was always below the limits of detection of the radioimmunoassay. In patients with asthma, histamine concentration increased from 5.3 +/- 0.6 ng/ml in lavages obtained before provocation to 20.2 +/- 5.8 ng/ml (mean +/- SEM; p less than 0.04) 5 minutes after bronchoprovocation. Peptide LTs increased from 0.32 +/- 0.08 to 0.82 +/- 0.21 ng/ml (p less than 0.02) and PGD2 from 0.06 +/- 0.01 ng/ml to 0.36 +/- 0.09 ng/ml (p less than 0.02). Elevated histamine, peptide LT, and PGD2 concentrations were also found in the 15-minute postchallenge BAL fluids. Similar results were obtained in patients with rhinitis. Histamine concentration was 3.4 +/- 0.6 ng/ml in prechallenge bronchial lavages and 11.3 +/- 1.7 ng/ml in postchallenge lavages; peptide LTs increased from 0.13 +/- 0.008 ng/ml to 0.73 +/- 0.21 ng/ml, and PGD2 from 0.05 +/- 0.01 ng/ml to 0.26 +/- 0.06 ng/ml.(ABSTRACT TRUNCATED AT 250 WORDS)