The late asthmatic response to allergen challenge--Part I

Of the 251 patients with bronchial asthma, 61 (24%) developed 83 late asthmatic (bronchus-obstructive) responses (LAR) to the bronchial challenge with allergen (BP). The LAR began within 6 to 12 hours, reached its maximum within 4 to 8 hours, and resolved within 24 to 26 hours after the allergen challenge. All LARs were highly significant in comparison with the control test (P less than .01). The LAR was observed either as an isolated late response (ILAR) in 35 cases (10%) or as a dual late response (DAR) in 48 cases (14%), being a combination of an immediate (IDAR) and a late response (LDAR). The LAR demonstrated six basic patterns. The association of LAR with other diagnostic parameters was as follows: positive disease history in 49 LAR cases (59%); positive late skin response (LSR) in 51 LAR cases (61%); increased total serum IgE in 17 LAR (20%); positive specific IgE in the serum in 24 LAR cases (29%); increased serum concentration of IgG in 55 LAR cases (66%), of IgM in 41 LAR cases (49%), of IgA in one LAR case (1%); increased serum concentration of IgG1 in seven LARs (8%), of IgG3 in 21 LARs (25%), of IgG4 in 43 LARs (52%), the serum concentration of IgG2 increased in two LARs, while it decreased in 45 LARs (54%); increased blood eosinophilia in 42 LAR cases (51%) and blood leukocytosis in 29 LAR cases (35%); increased body temperature in 15 LAR cases (18%); appearance of late bronchial complaints during 83 LAR cases (100%), and of general malaise complaints during 67 LAR cases (81%).(ABSTRACT TRUNCATED AT 250 WORDS)