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Volume 42, Issue 4
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Article type: Cover
1993 Volume 42 Issue 4 Pages Cover21-
Published: April 30, 1993
Released on J-STAGE: February 10, 2017
JOURNAL FREE ACCESSDownload PDF (692K) -
Article type: Cover
1993 Volume 42 Issue 4 Pages Cover22-
Published: April 30, 1993
Released on J-STAGE: February 10, 2017
JOURNAL FREE ACCESSDownload PDF (692K) -
[in Japanese]Article type: Article
1993 Volume 42 Issue 4 Pages 501-504
Published: April 30, 1993
Released on J-STAGE: February 10, 2017
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Hirokazu Nakajima, Takeshi Fukuda, Naohiko Ando, Sohei MakinoArticle type: Article
1993 Volume 42 Issue 4 Pages 505-513
Published: April 30, 1993
Released on J-STAGE: February 10, 2017
JOURNAL FREE ACCESSAlthough one of the mechanisms of glucocorticoid action in asthma is thought to be suppression of bronchial inflammation, there is little evidence to support this view. In the present study we have attempted to clarify the effect of oral glucocorticoid therapy on lymphocyte infiltration in the bronchial mucosa. Bronchial biopsies were obtained from 9 patients with asthma who had been taking oral prednisolone for at least the previous 18 days. They were stained immunohistochemically with a panel of monoclonal antibodies against: T cell subsets (CD3, CD4, CD8, CD57), and interleukine-2 receptor (CD25). The numbers of positive staining cells were counted for each antibody and compared with those in 11 patients with asthma who were symptomatic but had not been receiving glucocorticoid therapy for at least the previous one month. There was a significant decrease in the numbers of CD3-, CD4-, CD8- and CD57-positive cells in glucocorticoid treated asthmatics compared with those of symptomatic asthmatics. Moreover, when one patient who showed glucocoriticoid resistance was excluded from ttle analysis, there was a significant inverse correlation between the dose of prednisolone expressed as the total dose for the previous 2 weeks and the numbers of CD3- and CD4-positive cells. The number of CD25-positive cells (interleukin-2 receptor-bearing cells, presumed activated T-lymphocytes) also showed a tendensy to decrease but the difference was not statistically significant. These results suggest that oral glucocorticoids exert an inhibitory effect on T-lymphocyte infiltration in the bronchial mucosa, which could be a mechanism of their beneficial action in asthma.View full abstractDownload PDF (1138K) -
Hiroko Nogami, Reiko Kishikawa, Hiroshi Odajima, Hideto Tsurutani, Tak ...Article type: Article
1993 Volume 42 Issue 4 Pages 514-521
Published: April 30, 1993
Released on J-STAGE: February 10, 2017
JOURNAL FREE ACCESSTo characterize asthma in the elderly, we compared asthma in patients aged over 70 without chronic obstructive pulmonary disease with that in patients in their twenties. In the elderly, 65.5% of the patients had developed asthma after they were fifty years old. The mean duration from onset of asthma was 21.4 years. Of cases in the elderly, 42.1% were severe, and 93.0% were chronic type. IgE was significantly lower in the elderly than in those in their twenties. Among the patients in their twenties, the severe cases had early onset and long duration. In the elderly, however, there were no correlations between severity and age at onset or duration. Severe cases in their twenties had more obstructive ventilatory dysfunction in the stable state than the mild cases. In the elderly, however, the mild cases had the same level of obstructive ventilatory dysfunction as the severe cases. The elderly patients who had more than twenty years duration had lower V_<50> and V_<25> than those who had a less than twenty-year history. Small airway obstruction was observed in long-standing cases. As asthma in the elderly causes obstructive ventilatory dysfunction in the stable state, elderly patients might easily dovelop respiratory failure, even during mild attacks.View full abstractDownload PDF (819K) -
Ryo Soda, Kiyoshi Takahashi, Katsuhiro Miyashita, Sachie Katagi, Kouic ...Article type: Article
1993 Volume 42 Issue 4 Pages 522-528
Published: April 30, 1993
Released on J-STAGE: February 10, 2017
JOURNAL FREE ACCESSTo predict the clinical efficacy of house dust mite immunotherapy (IT), clinical factors before IT were analyzed in relation to clinical efficacy in bronchial asthmatics treated by standard IT method. In 111 asthmatics treated by IT, 88 cases (80%) obtained favorable results over a one-year period, while only 39% of asthmatics without IT showed clinical improvement (p<0.05, χ^2 test). Factors including severity, skin test threshold, age, age at which IT was started, duration of asthma, onset of asthma, FEV_<1.0>% and serum IgE levels before IT were analyzed. Severity showed the most significant influence on clinical efficacy (r=0.412, p<0.01). A study to determine whether some specific criteria could be used to predict the clinical efficacy of IT was then carried out. Using multivariate analysis with the factors above mentioned, the clinical efficacy ranging from deterioreated to good response could be expressed as a formula with a multi-reggression coefficient of 0.56, p<0.05. Moreover, the application of liniar discriminating analysis gave an 80% true positive discriminating rate in 75 asthmatics. In both methods, severity seemed to be the most important factor, skin test threshold next and FEV<1.0>% third. The other factors were not significant. Hopelly, the use of this formula in clinical practice will improve the efficacy of IT, thus providing further therapeutic benefits to bronchial asthmatics.View full abstractDownload PDF (725K) -
Katsuya Fujimori, Atsunori Takemoto, Takashi Hasegawa, Mayumi Sasagawa ...Article type: Article
1993 Volume 42 Issue 4 Pages 529-533
Published: April 30, 1993
Released on J-STAGE: February 10, 2017
JOURNAL FREE ACCESSWe studied the clinical factors which have the greatest effect on bronchial hyperresponsiveness, with 37 atopic asthma patients (23 males and 14 females). They were from 13 to 59 years old. We measured the control value of the respiratory conductance (Grs. cont), the minimum dose of methacholine (bronchial sensitivity, Dmin), the linear slope of the Grs (=1/Rrs) decreased (bronchial reactivity, SGrs) and SGrs/Grs. cont by the "Astograph" method (Chest 80, 600, 1981). Statistical analysis was performed by multiple regression analysis. Grs. cont, log Dmin, SGrs and SGrs/Grs. cont were regarded as objective variables. Age, onset age of asthma, period of disease, smoking history, family history of atopy, serum IgE, blood eosinophil counts, positive skin test counts, FEV_<1.0>% and type of asthma attack (perennial or seasonal) were regarded as explanatory variables. The results were as follows: 1) The explanatory variable which showed the highest partial correlation coefficients, was the type of asthma attack in multiple regression analysis of Grs. cont and log Dmin (p<0.05, p<0.05). 2) Grs. cont of perennial asthma attack (0.247±0.064) was significantly lower than that of seasonal attack (0.318±0.097) (p<0.02). Log Dmin of perennial asthma attack (-0.837±0.457) was significantly lower than that of seasonal attack (-0.254±0.429) (p<0.005). Therefore in mild atopic asthma, the clinical factor which has the greatest effect on bronchial hyperresponsiveness is the type of asthma attack. We conclude that the existence of perennial asthma attacks is mostly related to increased bronchial hypersensitivity.View full abstractDownload PDF (554K) -
Tohru Majima, Hidetsugu Katoh, Nagami Yoshida, Yoshihiko Akiyama, Naom ...Article type: Article
1993 Volume 42 Issue 4 Pages 534-540
Published: April 30, 1993
Released on J-STAGE: February 10, 2017
JOURNAL FREE ACCESSTo evaluate the clinical efficacy of high dose inhaled steroids, we examined the effects of standard doses (400μg/day) and high doses (800μg/day) of inhaled beclomethasone dipropionate (BDP, Becotide Inhaler), and the dose for regular use (800μg/day) of salbutamol (Salb. Asmidon Air) on pulmonary function, bronchial hyperresponsiveness and asthma attack score. The subjects were 17 out-patients with mild or moderate bronchial asthma who were not receiving any anti-allergics or steroids. The patients were randomly allocated into three groups i.e., Group I: BDP 400μg/day, Group II: BDP 800μg/day and Group III: Salb. 800μg/day. The administration period was 8 weeks. Pulmonary function test were performed and bronchial hyperresponsiveness was examined before and after the 8 weeks of treatment and attack scores were recorded during this period. It was found that inhalations of 400μg/day and 800μg/day BDP improved FEV_<1.0>% value, peak flow, F-V curve, Dmin. and SGrs/Grs cont. Particulary, inhalation of 800μg/day of BDP significantly improved these values and reduced attack scores in the early stages of the 8 week treatment. In contrast, there was a trend for inhalation of Salbutamol to enhance bronchial hyperresponsiveness and not to improve pulmonary function and asthma attack score. In conclusion, 800μg/day of inhaled BDP is considered to be useful in the treatment of mild or moderate bronchial asthma.View full abstractDownload PDF (715K) -
Kiyoshi Takahashi, Ryo Soda, Chiharu Okada, Hiroshi Nakatou, Koji Suna ...Article type: Article
1993 Volume 42 Issue 4 Pages 541-548
Published: April 30, 1993
Released on J-STAGE: February 10, 2017
JOURNAL FREE ACCESSThe eosinophil is a well-known leukocyte acting as an effector cell in the allergic reaction mechanism. The application of appropriate materials has led to more exact results from allergic examinations. In an effort to further improve analysis, we established a novel purification method for eosinophils using the flow cytometry (PCM) of peripheral blood and bronchoalveolar lavage fluid (BALF) leucocytes from healthy and allergic subjects. We examined the function of these cells in chemotaxis by platelet activating factor (PAF) and recombinant human (rh) IL-5. We obtained following results. First, we were able to separate human eosinophils containing autofluorescence substance, which was detectable by FCM employing a 450 nm argon ion laser. Second, the purity and recovery rate of the eosinophils were 90.1±4.2% and 32.1±7.6% in the healthy subjects who had no peripheral eosinophilia (<6%) and 93.7±4.4% and 37.2±7.5% in the allergic subjects who had eosinophilia (>6%). A relationship was readily apparent between the peripheral and purified eosinophil counts in the healthy subjects (r=0.62). Autofluorescence of the eosinophil fraction on PCM was further found to be decreased in patients with marked eosinophilia because of an increase in hypodense eosinophils. Third, highly purified eosinophils (76%) were also obtained from the 6.5% eosinophils present in the bronchoalveolar lavage fluid of one bronchial asthma patient. Fourth, the maximal chemotaxis of these eosinophils was shown at 10^<-6> M of platelet activating factor (PAF) and at 1μg/ml of IL-5 in a dose-dependent manner. This activity in allergic patients was accelerated compared with that in healthy subjects. Moreover, chemokinetic activity of rhIL-5 was also detected on the eosinophils. These data suggest that the application of eosinophils purified by PCM was quite useful in analyzing the pathogenesis of allergic diseases, since eosinophils can be highly purified from healthy subjects as well as from allergic patients, and because they are capable of preserving the essential cell functions.View full abstractDownload PDF (907K) -
Makoto Nagata, Takeshi Fukuda, Toshio Numao, Sohei Makino, Yutaka DohiArticle type: Article
1993 Volume 42 Issue 4 Pages 549-555
Published: April 30, 1993
Released on J-STAGE: February 10, 2017
JOURNAL FREE ACCESSIn order to evaluate the role of tumor necrosis factor alpha (TNFα) in the recruitment ot eosinophils and neutrophils into the tissues, we studied the effect of TNFα on the migration of those cells in vitro, employing a modified Boyden's chamber technique. TNFa induced a significant migration of human eosinophils in a dose-dependent manner, and the preincubation of eosinophils with TNFα enhanced platelet activating factor (PAF)-induced eosinophil migration. Checkerboard analysis revealed that the eosinophil migration induced by TNFα was mainly due to chemokinesis. On the other hand, TNFα induced neither neutrophil migration nor enhancement of PAF-induced neutrophil migration. These results indicate that TNFα possesses a chemokinetic effect on human eosinophils and that TNFα augments the migration of eosinophils by PAF.View full abstractDownload PDF (658K) -
Kenji Minoguchi, Mitsuru Adachi, Hisahiro Tokunaga, Yoshiki Gonogami, ...Article type: Article
1993 Volume 42 Issue 4 Pages 556-563
Published: April 30, 1993
Released on J-STAGE: February 10, 2017
JOURNAL FREE ACCESSAllergen inhalation challenge resulted in significant (p<0.05) increase in airway responsiveness to methacholine soon after immediate airway response (IAR) in guinea pigs actively sensitized with inhaled ovalbumin (OA) in vivo. We have investigated the involvement of thromboxane (Tx) A_2 and platelet activating factor (PAF) in this airway hyperresponsiveness (AH). Pretreatment with CS-518, a selective thromboxane synthetase inhibitor, significantly inhibited both IAR (p<0.07) and AH (p<0.01), while pretreatment with WEB 2086, a PAF receptor antagonist, significantly inhibited only IAR (p<0.05), but not AH after IAR. Propranolol, when inhalated before OA exposure, had no effect on bronchomotor tone, but if inhalated after IAR, it caused immediate death of guinea pigs. This result suggests that hyperresponsiveness of beta-adrenoceptor to propranolol may be induced by IAR. Examination of bronchoalveolar lavage (BAL) fluid revealed that no changes in cellular content were observed 60 min after OA exposure. In vitro, responsiveness of tracheal smooth muscle to carbachol was not changed by sensitization. Furthermore, anaphylactic reaction in vitro had no effect on the responsiveness. We conclude that airway responsiveness increases soon after IAR when infiltration of inflammatory cells is not yet found in vivo. It is also suggested that TxA_2 but not PAF is involved in AH. Hyperresponsiveness to propranolol after IAR in OA sensitized guinea pigs illustrates the possibility of changes in function of beta-adrenoceptor after IAR.View full abstractDownload PDF (802K) -
Kaori TsujiArticle type: Article
1993 Volume 42 Issue 4 Pages 564-570
Published: April 30, 1993
Released on J-STAGE: February 10, 2017
JOURNAL FREE ACCESSTo clarify the activation of peripheral blood T-cells in Kawasaki Disease (KD) patients, we investigated whether the expression of lymphocyte function-associated antigen-1 (LFA-1) and/or intercellular adhesion molecule-1 (ICAM-1) on peripheral blood T-cells and serum levels of soluble CD2 (sCD2) increase during the acute stage. Expression of cellular adhesion molecules was analyzed using flow cytometry. sCD2 levels in serum were measured by a sandwich enzyme immunoassay. There was a decrease in the number of CD3 + T-cells in the bright LFA-1α and LFA-1β population and a concomitant increase in the dim population of LFA-1α and LFA-1β during the acute stage, in comparison with the convalescent stage. In addition, we observed no significant differences in ICAM-1 expression between the acute stage and the convalescent stage. There were no significant differences in sCD2 levels among the acute stage, the convalescent stage and the control subjects. In our view the present data, in conjunction with previous reports on T-cell function during acute KD, suggest that sequestration of activated peripheral blood T-cells may be a feature of this disease.View full abstractDownload PDF (704K) -
Hiroaki YamaguchiArticle type: Article
1993 Volume 42 Issue 4 Pages 571-581
Published: April 30, 1993
Released on J-STAGE: February 10, 2017
JOURNAL FREE ACCESSTo evaluate the relation between immediate hypersensitivity and environmental factors, a total of 2,187 allergic children were given the intracutaneous skin tests (IC test) and specific IgE antibodies (RAST) at Kudanzaka Hospital over a period of 21 years (1967-1987). The incidence of positive IC test to house dust (HD) and Japanese cedar pollen (sugi) increased, and that to molds increased transiently in the period 1965-1975. There was no sex difference in the incidence. Asthmatic children with allergic rhinitis scored higher both in IC test and RAST than those with asthma only. The more severely asthmatic children had a higher incidence of positive IC test to HD, molds, sugi, ragweed, cat dander, silk and buckwheat (sobagara). The recent rise of in the number of allergic diseases was partly proved by higher positive IC tests to HD and sugi. The number of positive test to HD mites also increased because twice as many non-wooden houses as wooden houses, have been built since 1969, and there were 3 tines as many, high-rise building in 1975 as in 1965. Pollution and the increasing area of sugi forests were also responsible for increased allergic problems.View full abstractDownload PDF (1078K) -
Akira Akasawa, Kenji Matsumoto, Hirohisa Saito, Naoya Sakaguchi, Kazuk ...Article type: Article
1993 Volume 42 Issue 4 Pages 582-585
Published: April 30, 1993
Released on J-STAGE: February 10, 2017
JOURNAL FREE ACCESSMany cases of latex-induced intraoperatived anaphylaxis have been reported in Europe and the U.S. but not in Japan. We measured latex-specific IgE antibody in sera from the 108 atopic children with high serum IgE levels (over 1,000 U/ml). All of them were diagnosed to have asthma, atopic dermatitis and/or food intolerance. Eleven (10.2%) out of 108 patients were found to have latex-specific IgE by RAST, and 6 of them were positive for latex antigen by skin test. Most of the children did not realize that they were allergic to latex until we discovered it. This data suggest that we should be cautious about latex allergy when atopic children have to be operated upon.View full abstractDownload PDF (363K) -
Article type: Appendix
1993 Volume 42 Issue 4 Pages 586-
Published: April 30, 1993
Released on J-STAGE: February 10, 2017
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Article type: Appendix
1993 Volume 42 Issue 4 Pages 587-
Published: April 30, 1993
Released on J-STAGE: February 10, 2017
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Article type: Appendix
1993 Volume 42 Issue 4 Pages 587-
Published: April 30, 1993
Released on J-STAGE: February 10, 2017
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Article type: Appendix
1993 Volume 42 Issue 4 Pages 588-
Published: April 30, 1993
Released on J-STAGE: February 10, 2017
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Article type: Appendix
1993 Volume 42 Issue 4 Pages 589-592
Published: April 30, 1993
Released on J-STAGE: February 10, 2017
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Article type: Cover
1993 Volume 42 Issue 4 Pages Cover23-
Published: April 30, 1993
Released on J-STAGE: February 10, 2017
JOURNAL FREE ACCESSDownload PDF (69K)
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