花粉症の研究 : II花粉による感作について

抄録

Incidence of sensitization with several air-borne pollens was studied in the Japanese mainly by direct intradermal test, and in some cases Prausnitz-Kustner test, eye test, and provocation by pollen inhalation were studied also. Individuals tested were 265 patients with bronchial asthma, 70 patients with nasal allergy and 602 control persons. Pollens used were short ragweed (Ambrosia artemisiifolia var. elatior), Japanese red pine(Pinus densiflora), Japanese black pine (Pinus Thumbergi), Japanese cedar (Cryptomeria japonica), and Japanese hop (Humulus japonicus). For the comparative study, house dust was also used. In direct skin testing, 0.05 ml of allergen extracts of 1:1000 dilution was injected intracutaneously. In asthmatic patients, each of the distribution curves of diameters of erythema and wheal caused by the intradermal injection with house dust extract showed two peaks with a minimum between them, and the minimum point situated at 15〜20 mm in erythema and 9 mm in wheal. Similar figures were obtained in normal control persons. With short ragweed pollen, it was the same. The first peak, which was estimated to correspond to unspecific reactions, was lower than that of normal control persons, while the second peak which was considered to correspond to specific reactions was higher in asthmatic patients. Only few normal persons and fairly numerous asthmatic patients showed the erythema reactions above 41 mm in diameter. The correlation between erythema and wheal was high (r=0.80 in house dust. r=0.78 in ragweed pollen). From these results. the author proposed the following criteria of intradermal skin test with inhalant allergens; negative (-): erythema less than 10 mm in diameter doubtful (±): erythema 11-20 mm slightly positive (+): erythema 21-40 mm, wheal less than 9 mm moderately positive (〓): erythema 21-40 mm, wheal 10-14 mm strongly positive (〓): erythema above 41 mm, or wheal above 15 mm, or with marked pseudopods After these standards, positive skin reactions to short ragweed pollen were observed in 36% of asthmatic patients, 32% of patients with nasal allergy including bacterial allergy, 52% of patients with nasal allergy except bacterial allergy, and 19% of normal control persons, whereas positive skin reactions to house dust in these four groups were 69%, 51%, 65%, and 23% respectively. But positive skin reactions to Japanese red pine and Japanese cedar pollens were observed far less frequently than that to ragweed pollen, and only very few cases reacted to Japanese black pine and Japanese hop pollens. PK-test was successful in 7 of 11 cases who showed positive intradermal reaction to short ragweed pollen, and in 2 of 3 cases who showed positive intradermal reaction to Japanese red pine pollen. Eye test was carried out with the extracts of pollens, and provocative test by inhalation was done with pollen itself. Both of these test showed positive reactions in rather few cases. Cross reaction between house dust and short ragweed pollen were proved by PK-reaction. House dust might have more allergenic components than short ragweed pollen as judged by skin test. A Japanese patient, who never been abroad but suffering from allergic rhinitis and laryngitis evidently caused by short ragweed pollen, was described in details. Some possible explanations concerning the discrepancy between the results of skin test and the incidence of pollinosis were discussed.