Japanese Journal of Allergology

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We reported clinical and laboratory findings of 5 patients with Churg-Strauss syndrome (CSS), especially association with asthma symptoms. Subjects included 3 males and 2 females with a mean age of 53.8 year-old. In all 5 patients symptoms of neuropathy; mononeuritis multiplex and in some patients, other vasculitic symptoms; fever, diarrhea, abdominal pain and skin eruptions, were noted. These clinical features and laboratory findings; marked peripheral eosinophilia and elevation of serum ECP were normalized after steroid therapy. We investigated the relation between the occurrence of CSS and the symptoms of asthma. The mean duration of asthma in this series was 17.2 years, and 4 cases were atopic and one was non-atopic asthma. In previous publications, asthmatic symptoms were severe at the onset of the disease and progressed thereafter. In our 5 cases, however, the severities of bronchial asthma were mild of two cases, moderate of two and severe of only one, moreover severe asthmatic attacks were shown in only 2 cases when the manifestation of systemic vasculitis occurred. In conclusion, although CSS has been thought that one of complications of bronchial asthma, the occurrence of CSS are not necessarily corelated with symptoms of broncial asthma.

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We measured serum ECP levels in infants during first wheezing episode. Serum ECP in these infants are significantly higher than in conrol infants, although much higher in children with asthma. Serum ECP in these infants with high serum IgE and/or positive RAST score are higher than in infants with normal serum IgE and negative RAST score. In children with bronchial asthma serum ECP is correlated with peripheral eosinophil counts, but in infants during first wheezing episode serum ECP is often elevated not associated with increased peripheral eosinophil counts. These suggest that activated eosinophils could be responsible for bronchoconstriction in wheezing patients with atopic diathesis even in very early phase and that these eosinophilic inflammations could contribute to formation of increased airway reactivity and bronchial asthma.

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To determine whether ONO-1078, leukotriene receptor antagonist, inhibits the activation of eosinophils, we investigated the effect of ONO-1078 on the release of leukotriene (LTC_4) and eosinophil cationic protein (ECP) from human peripheral blood eosinophils of allergic patients and normal subjects. After preincubation with ONO-1078, eosinophils were incubated with calcium ionophore (A23187). ONO-1078 10^<-5> and 10^<-6>M inhibited LTC_4 release of allergic patients eosinophils and 10^<-5>〜10^<-9> M inhibited LTC_4 release of normal subjects eosinophils. ONO-1078, 10^<-5> M, also inhibited ECP release of eosiophils obtained from both asthma patients and normal subjects. We think that ONO-1078 may have another pharmacological effect to prevent the activation of human peripheral blood eosinophils by inhibiting LTC_4 and ECP release. These results suggest that ONO-1078 might be useful in controlling bronchial asthma.

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Peripheral mononuclear cells from 47 patients suffering from Japanese cedar pollinosis were stimulated with crude pollen extract of Cryptomeria Japonica (CJ) to evaluate the effect of CJ-specific immunotherapy. The stimulation index (SI) with crude pollen extract of CJ in the patients with excellent and good clinical outcome was significantly lower than those with poor outcome. The SI increased with the increasing symptoms in a dose dependent manner. In the patients under immunotherapy for long period, the good clinical outcome and low SI were gained. These results suggest that peripheral lymphocyte proliferation test should be a good objective indicator for allergen-specific immunotherapy.

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