[Lung function values in inhalative provocation with allergens. In immediate reactions, delayed reactions and...

The question: in which parts of the lungs do obstructions occur after inhalative provocation with immediate and delayed reactions, and after bronchospasmolysis, has been investigated. The following parameters were measured in more than 30 children with delayed and more than 70 children with immediate responses: FEV1, MF25-75%, PF, RawOS (oscillometrically), Raw (shutter) employing the shutter method, Rawtot, TGV, RV, RV/TLC and AEX (area under the expiratory flow-volume curve. The above parameters were determined prior to, during the positive immediate and delayed reaction, and after bronchospasmolysis. The examinations were carried out with the body plethysmograph manufactured by Ganshorn-Electronic, and the FD-5 (Siregnost) made by Siemens. The allergens: hous dust mites (D. pteronyssinus and D. farinae), grasses and fungi (Alternaria, Cladosporium, Aspergillus and Penicillium) obtained from the firm of Bencard, were nebulized in increasing concentrations, using the ultrasound nebulizer manufactured by Heyer. The forced spirogram, in the first instance FEV1, permits the best assessment of the changes occurring in the lungs during these challenges. A breakdown in terms of MIF25-75% permits assignment to the deeper and higher airways. In the case of the immediate reactions, the inhalation of beta-sympathomimetics leads to complete bronchospasmolysis, while in the case of the delayed reaction, bronchospasm is no longer fully reversible owing to oedema and inflammation. This can be documented with the aid of the parameter FEV1, MF25-75%, PF, AEX and RV. The examinations using the oscillometric RawOS method are the least suitable for establishing the late reactions or residual obstruction following bronchospasmolysis.