One of the anaphylatoxins, C5a, is known to increase the expression of the complement receptors, CR1 and CR3, on PMNs which play important roles in the phagocytosis. We measured the expression of these receptors before and after the stimulation with C5a and C5a-receptors (C5aR) on PMNs in patients with systemic lupus erythematosus (SLE). PMNs from 1.6 patients and 11 normal controls were tested. All the patients with SLE were administered with prednisolone orally and were in the inactive stage. The CR1 expression in SLE was significantly weak (p<0.01) before and after stimulation with 4.55 nM (50μg/ml) of C5a. There was no significant difference of CR3 expression before stimulation. However, after the stimulation with C5a, the increase of CR3 on PMNs from SLE was significantly small (p<0.01). C5aR on PMNs showed no difference between the two groups. However, the expression of C5aR was significantly suppressed iln patients treated with a high dosage of prednisolone (>=10 mg/day) compared to those with a low dosage of prednisolone (<10 mg/day). There was no significant difference of CR1 and CR3 expression between these groups. It is concluded that the increase of CR1 and CR3 on PMNs by C5a in small in SLE, of which impaired increase is not due to C5aR on PMNs, and that the expression of C5aR is suppressed by prednisolone.

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We performed a questionnaire survey of Japanese cedar pollinosis among 7,946 residents of the Sakashita region (Mitsune, Ogago) and Sakaue region (Kashidate, Sueyoshi, Nakanogo) of Hachijyojima who were at least 15 years of age. The response rate was 21.3%. The percentage of respondents who reported three or more nasal symptoms concurrentry with two ocular symptoms in early spring (from the end of February to the end of March) was 1.8% in the Sakashita region and 0.3% in the Sakaue region. About 1.5% of Hachijyojima residents were suspected to have Japanese cedar pollinosis. On scratch tests of symptomatic subjects, 9.2% showed positive reactions for Japanese cedar antigen, and 12.1% had an IgE RAST score of 2 or more. The peak Japanese cedar pollen concentration between February 11 and March 31, 1992 was 74/cm^2 on March 6 in the Sakashita region and 127/cm^2 on the same day in the Sakaue region. This survey confirmed the presence of a low incidence of Japanese cedar pollinosis in Hachijyojima, an isolated island 290 km from Tokyo

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Orthostatic dysregulation (OD) has been reported to be complicated with childhood bronchial asthma. 42 patients (28 females and 14 males) with adult-onset bronchial asthma were selected randomly to investigate the prevalence of OD. OD was diagnozed by both questionaire for subjective symptoms and tilting test (Schellong test and upright ECG). Our results revealed that 64.3% (both 64.3% in females and males) of the patients were complicated with OD. There was no significant difference in the duration of asthma, FEV_<1.0>, %FEV_<1.0>, serum IgE level, and severity of asthma between patients with OD and without OD. Furthermore, no significant difference in the results of tilting test were observed. In serum level of theophylline we couldn't detect any subjective difference between the two groups, however there was significant difference between positive patients and negative patients in tilting test. In conclusion, OD is frequently complicated with adult-onset asthma and we should be careful of the subjective symptoms concerned with OD.

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The aim of this clinical study was to investigate the influence of beclomethasone dipropionate (BDP) inhalation therapy on respiratory bacterial infection in patient with an asthmatic attack. We studied 267 asthmatic attack episodes of 241 patients with/without BDP inhalation therapy. There was no difference between two groups in %peak flow, body temperature, CRP, WBC count, bacterial culture of sputum on admission. BDP inhalation therapy has little influence on respiratory bacterial infection at an asthmatic attack.

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In order to investigate the role of tumor necrosis factor alpha (TNF-α) in bronchial asthma or chronic respiratory infection, we measured serum levels of TNF-α and serum soluble tumor necrosis factor-receptor I (sTNF-R I) in asthmatic patients (n=11) and patients (n=10) with chronic respiratory infection by Rseudomonas aeruginosa. We also measured serum levels of eosinophil cationic portein (ECP) in the asthmatic patients. The serum levels of TNF-α in the asthmatic patients, patients with chronic repiratory tract infection and control group were 2.864±0.719 g/ml, 2.564±1.384 pg/ml and 0.681±0.453 pg/ml respectively. The levels of the former two groups were higher than those of the control group (p<0.05). The serum levels of sTNF-RI in the asthmatic patients, the patients with chronic respiratory tract infection, and the control group was 758±268 pg/ml, 999±242 pg/ml and 909±268 pg/ml respectively. The levels of the former two groups did not differ significantly from those of the control group. There were significant correlations between TNF-α and sTNF-RI in the control group and in the patients with chronic respiratory tract infection, but there was no significant correlation in the asthmatic patients. In the asthmatic patients, TNF-α/sTNF-RI correlated with %best of PEF (r=0.691, n=9, p=0.0373). The serum levels of ECP correlated significantly with TNF-α, but not with sTNF-RI in the asthmatic patients. It is suggested that TNF-α plays a significant role in the pathogenesis of bronchial asthma and chronic respiratory tract infection as a factor causing inflammation and that the increase of TNF-α/sTNF-RI reflects the activation of eosinophil functions in an asthmatic attack.

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The patient was complicated by type C hepatitis considered dur to blood preparations during the treatment of acute lymphoblastic leukemia. On administration of Sho-saiko-to, the white blood cell count decreased. When the drug was administered again, interstitial pneumonia developed concurrently. The case is a 7-year-old boy. He is the youngest to suffer interstitial pneumonia due to Sho-saiko-to in Japan, showing the possibility that interstitial pneumonia occurs even in childhood. A study of the IgG subclass at the time of the development of interstitial pneumonia in the affected child showed an imbalance of the subclass, with an increase in the percentage of IgG1 and IgG3, and a decreased in the percentage of IgG2 and IgG4. With improvement in the symptoms thereafter, however, the IgG subclass normalized. Thus it is possible that the IgG subclass is concerned with the development of interstitial pneumonia in this case. So, making careful observations is needed in administering Sho-saiko-to to children with type C hepatitis who use various immunosppressants.

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We studied chest X-rays of 911 patients with rheumatoid arthritis (RA). The findings showed interstitial shadow in 28 patients (3.1%), pleuritis in 13 patients (1.4%) and nodular shadow in 3 patients (0.3%). RA patients with interstitial pneumonia were commonly male and older. And they had significantly high levels of rheumatoid factor (RF), RAPA and IgG-RF in serum, but they were not associated with high score of Lansbary index. All patients with more than 1500 IU/ml in RF value had a complication of interstitial pneumonia. These results suggest the importance of chest X-ray in the management of RA patients with high titer in RF.

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Levels of specific IgE antibodies to three kinds of venom (honeybee, wasp and yellow jacket) were followed up for two years in five male pest control operators (age: 24 to 50 years) with Hymenoptera sting within the latest six months. At the first examination, all subjects had a positive reaction for venom-specific IgE but their levels were varied in the range from class 2 to 5 (0.70〜99.9 UA/ml), and a positive reaction was observed in the case of unoffending Hymenoptera. A subject who was re-stung during the two year follow-up period showed increase in all of the venom-specific IgE levels. Of four subjects without re-stung during the two years, three subjects had a logarithmic decrease in all the specific IgE levels time-dependently, but one subject with a high total serum IgE level showed an increase and decrease alternately in the specific IgE. The total serum IgE level may be a factor which influences the change in the venom-specific lgE level. In the four subjects without a high total serum IgE level, the biological half-life of venom-specific IgE was estimated to be 6 to 12 months based on the decreased level during the follow-up period.

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It is revealed that patients allergic to a water-soluble fraction from wheat flour were sensitive to pineapple enzyme, bromelain. Since bromelainhas a highly similarity to other SH-proteases such as papain, it may imply that the patients may recognize varieties of other SH-proteases as the epitope.

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