Diagnostic and prognostic significance of studying histocompatibility antigens in patients with bronchial asthma

As a result of a comprehensive clinical and functional examination of 217 patients with bronchial asthma, including study of HLA-antigen composition of their tissues, a relationship between B13, B21 and B35 antigen carriers and susceptibility to bronchial asthma as well as associations with the form of the disease, its severity and some features of its course were found. Clinical examples confirming these arguments are illustrated. Possibilities of individual prognosis at a clinic are grounded.     

The significance of immunogenetic body characteristics in the formation and development of bronchial asthma]

The antigenic composition of tissues was shown to be of importance in the formation of bronchial asthma on the basis of the clinicoimmunological data with regard to histocompatibility antigens in 235 patients suffering from bronchial asthma and preasthma. Well-defined correlations were established between the development of bronchial asthma with carriership of antigens A2, B13, B21 and B35, between the disease pattern and nature of its course and antigens B7, B12, B27, B35, B40 together with their combinations. Possible variants of the relationship between the body traits and certain mechanisms by which bronchial asthma develops are under discussion.     

Mechanisms of asthma of effort

Forty-six patients with bronchial asthma and preasthma and 6 normal persons were examined before and after graded exercise. Measurements were made of changes in glycogenolysis in peripheral lymphocytes, in blood plasma osmolarity, external respiration function ad diffusion capacity of the lungs, and of blood and sputum eosinophilia. Some of the patients were also examined for blood content of catecholamines. The group of patients with asthma of effort showed, in contrast to those without that illness, the signs of allergic inflammation of the distal parts of the bronchi and a direct correlation between changes in plasma osmolarity and glycogen content in lymphocytes, a decrease in the grade of the glycogenolytic response to adrenaline after exercise. It seems likely that in the pathogenesis of asthma of effort, of certain importance is inadequate reaction of the adrenoreceptor apparatus of the cells to the changes in the microenvironment provoked by exercise, which is manifested by the lack of the rise of beta-adrenoreactivity.     

The role of serotonin, histamine and the kallikrein-kinin system in the pathogenesis of asphyxic attacks in bronchial asthma]

Altogether 300 patients suffering from bronchial asthma were examined for serotonin metabolism, the kallikrein-kinin system and histamine. A study was also made of the information relations of the indicated parameters to diverse groups of the signs using Shannon's technique. It has been revealed that serotonin and the kallikrein-kinin system are of importance in the pathogenesis of changes in the efficacy of the diffusion lung capacity in severe bronchial asthma. The authors discuss the significance of excessive accumulation of serotonin and bradykinin as a marker of the impairment of endothelial function of pulmonary vessels, specified by the damaging action of free radicals and immune complex allergic vasculitis as well. Histamine along with macrophages act as delimiters of allergic inflammation, with their action being mediated by negative feedback.