The relationship between bronchial hypersensitivity and the prognosis of bronchial asthma

I measured RT-Ach, RT-Hist and EIA of asthmatic children every year and studied the relationship between these three parameters and their prognoses. I obtained the following results. 1) If the patient's RT-Ach and EIA improved in three years, I could say that his clinical symptoms had improved and his prognosis was good. RT-Hist results, however, would be unchanged even if clinical symptoms improved. 2) In asthmatic children, EIA is important for short term prognoses while RT-Hist is important for long term prognoses.     

Metabolic aspects of bronchial hyperreactivity to physical exertion in bronchial asthma

The blood levels of stress mediators--catecholamines (adrenaline and noradrenaline), parameters characterizing the intensity of lipid peroxidation (hydroperoxides, blood antioxidant activity (from the levels of SH groups), and the content of prostaglandins F2 alpha and E (PGF2 alpha and PGE) were measured in patients with bronchial asthma and chronic asthmatic bronchitis before and after exercise. The studies have revealed that bronchial hyperreactivity to exercise is in accord with the high blood levels of catecholamines, hydroperoxides, PGF2 alpha and low content of thiol group reflecting the depression of the total antioxidant system in asthmatics. Increase of catecholamine, hydroperoxide, and PGF2 alpha levels and decrease of the total thiol group content after muscular exercise in the patients with bronchial asthma is in accord with the bronchial reactivity. Changes in the bronchoconstrictor PGF2 alpha are the most marked and measurements of its blood levels and computation of the PGF2 alpha/PGE coefficient may help assess the bronchial hyperreactivity without resorting to provocative tests.     

Immunopathogenesis of bronchial asthma

Bronchial asthma is a common immune-mediated disorder characterized by reversible airway inflammation, mucus production, and variable airflow obstruction with airway hyperresponsiveness. Allergen exposure results in the activation of numerous cells of the immune system, of which dendritic cells (DCs) and Th2 lymphocytes are of paramount importance. Although the epithelium was initially considered to function solely as a physical barrier, it is now evident that it plays a central role in the Th2-cell sensitization process due to its ability to activate DCs. Cytokines are inevitable factors in driving immune responses. To the list of numerous cytokines already known to be involved in the regulation of allergic reactions, new cytokines were added, such as TSLP, IL-25, and IL-33. IgE is also a central player in the allergic response. The activity of IgE is associated with a network of proteins, especially with its high- and low-affinity Fc receptors. Understanding the cellular and molecular mechanisms of allergic reactions helps us not only to understand the mechanisms of current treatments, but is also important for the identification of new targets for biological intervention. An IgE-specific monoclonal antibody, omalizumab, has already reached the clinic and similar biological agents will surely follow.