AUTOIMMUNE PHENOMENA IN BRONCHIAL-ASTHMA WITH SPECIAL REFERENCE TO ASPIRIN INTOLERANCE

We assessed the autoimmune status of 185 adult patients with bronchial asthma and 46 healthy subjects of similar sex and age. The patients w ere divided into groups with: (1) aspirin-induced asthma (AIA) (n = 80 ); (2) intrinsic asthma with good aspirin tolerance (n = 46); and (3) atopic asthma (n = 59). Antinuclear antibodies (ANA) at a titer of gre ater than or equal to 1:40 were present in the serum of 55% of the pat ients with AIA, 41% of those with intrinsic asthma, 39% of those with atopic asthma, and 11% of the healthy subjects, with the difference be tween each patient group and the healthy subjects being statistically significant (p < 0.05). The fluorescence staining pattern of ANA on He p-2 cells was mainly speckled, but the precise antigen specificity of the antibodies could not be identified with reference sera against ext ractable nuclear antigens. None of the subjects exhibited anti-double stranded deoxyribonucleic acid (anti-ds-DNA) or anti-neutrophil cytopl asmic antibodies (ANCA). Positive ANA were associated with signs of co mplement activation, the presence of rheumatoid factor, and circulatin g immune complexes. Clinical signs of autoimmunity, evidenced by rheum atic symptoms, cold sensitivity, and Raynaud's phenomenon, were more c ommon among the patients who tested positively for ANA. The assessment of autoimmunity may help in better characterizing patients with asthm a and understanding various symptoms of the disease. Any causal relati onship between asthma and autoimmunity remains to be established.