Japanese Journal of Allergology

We studied the correlation between late phase reaction (LPR) and laboratory data in atopic dermatitis (AD) and evaluated the pathological findings in LPR. We studied the correlation between LPR and the severity of AD, total IgE, specific IgE, total IgG4, specific IgG4 and eosinophils. There were correlations between immediate reaction (IR) and some laboratory data, but not between LPR and laboratory data. Pathological findings at 15 min 24 hrs and 48 hrs after dermal injection showed dermal edema at 15 min, followed by epidermal eczematous changes in almost all cases at 24 hrs, edema and degeneration of dermal endothelial cells and surrounding connective tissue, and leukocytoclasia in half of the cases and deposition of C3 and IgG in parts. We found CD4^+ cells in all layers of dermis, a greater ratio of EG2^+ cells in deeper layers of dermis as time passed, and decrease of CD23^+ cells after 24 hrs throughout the dermis. These changes were found in cases of IR-LPR^+, too. It appears that the mechanism of LPR is complex and that IR is not indispensable, for LPR and that infiltration of CD4^+ and EG2^+ cells throughout all layers of dermis are important, and these condition were related to subsequent reactions.

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Postinfectious cough has been drawing attention as a factor involved in the etiology of chronic cough in the United States. In Japan, clinical features of postinfectious chronic cough (PICC) have not been described in detail. We investigated 22 patients with PICC diagnosed by the established criteria (Jpn. J. Allergol. 1995; 44: 1418). All patients were nonsmokers and none received ACE inhibitors. None had a history of atopy or sinus diseases. There were four men and 18 women with a median age of 65 years. These 22 patients underwent clinical examinations including chest roentgenograms, respiratory function tests, eosinophil counts in venous blood, serum IgE titers, antibody titers to Mycoplasma pneumoniae, sputum cytologic findings taken from ten patients, and histological features of bronchial biopsy specimens obtained from two patients; all findings were within normal limits. Clinical course of cough in 20 of the patients with PICC was evaluated using a cough diary. One patient did not keep a cough diary. Ten patients improved with dextromethorphan hydrobromide (D) and oxatomide (O). Three of the remailling 9 patients improved with Bakumondo-to (B) only, 4 with D + O + B, and 2 with D + O + B + ozagrel hydrochloride. The duration of cough before treatment showed a significant correlation with the time from the start of treatment to recovery (r=0.47, p<0.05). These results indicate that PICC tends to occur in elderly women and to improve with treatment combining with D, O, and B. We hope to establish a standard therapy for postinfectious chronic cough.

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We studied the effects of SDZ ISQ 844, a cyclic nucleotide phosphodiesterase (PDE) isozyme type III/IV inhibitor, and salbutamol on the release of histamine from activated human peripheral leukocytes. We stimulated the leukocyte suspensions with calcium ionophore A23187 (Ca-I, 10^<-6> M) accompanied with SDZ ISQ 844 (10^<-7> M, 10^<-6> M, 10^<-5> M), salbutamol (10^<-7> M, 10^<-6> M, 10^<-5> M) and combination of SDZ ISQ 844 and salbutamol (10^<-7> M, 10^<-6> M, 10^<-5> M), and measured the levels of histamine in the supernatant fluid and total cyclic AMP levels in the leukocyte suspensions. The increase of histamine levels induced by Ca-I was significantly inhibited by SDZ ISQ 844 (10^<-6> M, 10^<-5> M) in a dose-dependent manner (p<0.05, p<0.01). Salbutamol at the concentration until 10^<>5 M did not inhibit the increase of histamine levels. Combination of SDZ ISQ 844 and salbutamol significantly inhibited the increase of histamine levels (10^<-6> M, 10^<-5> M) in a dose-dependent manner (p<0.05, p<0.01). The inhibition of the histamine release by SDZ ISQ 844 (10^<-5> M) was enhanced significantly by salbutamol (10^<-5> M) (p<0.05). Total cyclic AMP levels in the leukocyte suspensions increased significantly by SDZ ISQ 844 (10^<-5> M) and combination of SDZ ISQ 844 and salbutamol (10^<-6> M, 10^<-5> M) in a dose-dependent manner (p<0.05, p<0.01). The increase of cyclic AMP levels by SDZ ISQ 844 (10^<-5> M) was enhanced by salbutamol significantly (p<0.01). These results suggest that selective inhibition of PDE isozyme type III/IV protects the release of histamine from human activated leukocytes in connection with intracellular cyclic AMP levels and the protection is enhanced by β-agonist.

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