気管支喘息におけるカンジダ抗原吸入誘発試験の臨床的検討―遅延型気道反応を中心に―

Various allergic mechanisma participate in the reversible bronchospasms of an asthma attack. Candida albicans was suspected as the causative antigen in late-onset and severe intractable asthma. In this study, inhalation provocation test was performed with Candida antigen to evaluate the asthmatic responses of asthmatic patients with positive skin reaction to Candida antigen. More than 20% decrease in park flow after antigen inhalation was considered an asthmatic response and such responses were classified as immediate (IAR), late (LAR) or delayed (DeAR) depending on the time course after antigen inhalation. Provocation tests induced asthmatic responses in 26(42.6%) patients and 11(42.3%) showed DeAR. Eight of the 11 patients with DeARs had late onst asthma and 7 patients had intractable asthma. Furthermore, patients with DeARs showed higher lymphocyte responses to Candida antigen than those with IAR or LAR. These date indicate that EeAR to Canidia antigen plays an important role in the pathogenesis of severe intractable asthma.

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