Action of cromoglycate in relation to mediators

The inhalation of salts of platinum, isocyanate and pine resin are mentioned as examples of immediate asthma reaction type I, which often shows IgE antibodies. Long before the onset of occupational asthma, exercise-induced asthma can exist in a sensitized stadium. Histamine is less involved in immediate asthma type I and in exercise-induced asthma. Unlike antihistamines, cromoglycate (DSCG) protects against attacks of the immediate type. SRS inhibitors are also effective prophylactically. SRS has an asthmagenic effect after mast cell degranulation and probably also after neutrophil degranulation. It is interesting that DSCG also inhibits the late reaction (re-outbreak or outbreak of asthma some hours after exposure). The reason for this is unknown. As DSCG reacts against late asthma even if inhaled after exposure, this explains the effectiveness of DSCG inhaled 3-hourly. In cases where IgG4 attaches itself to IgE which is fixed to the mast cell, an intrinsic asthma which shows normal IgE in circulating blood may be induced. It is worthwhile using DSCG in this instance.