難治性喘息の発症病態に関する研究　第1編　難治性喘息の臨床的検討

To clarify the pathogenesis of intractable asthma, clinical features, allergic examinations, pulmonary functions and histological finding were evaluated in 27 intractable asthmatics compared with 33 non-intractable asthmatics. Almost all of the intractable asthmatics had chronic and perennial asthma attacks and also had highly frequent episodes of respiratory infection. IgG-as well as IgE-mediated allergic reactions were proved by the findings of skin reaction, IgE RAST score, precipitating antibody and reactivity of basophils to anti-immunoglobulin antisera in the intractable asthmatics but not in the non-intactable asthmatics. Neutrophils of BALF and peripheral blood increased markedly in the intractable asthmatics as compared with the non-intractable asthmatics. The fall of % V(25) on flow volume curve in the intractable asthmatics, indicated small air way obstruction. Micronodular shadows on the chest X-ray film were frequently seen in the intractable asthmatics. Many histological findings were shown on lung specimens obtained by TBLB in the intrac-table asthmatics. These findings indicate that multiple factors of allergic reaction mediated by IgG, migrated neutrophils and organic changes of lung tissue lead to severe and intractable asthma attack.