CHEMICAL MEDIATOR AND CELLULAR REACTION IN THE BRONCHOALVEOLAR LAVAGEFLUID OF PATIENTS WITH STEROID-DEPENDENT INTRACTABLE ASTHMA (SDIA)

The effects of long-term glucocorticoid therapy on chemical mediator a nd cellular reaction in the airways were examined in 69 patients with bronchial asthma. The histamine release induced by Ca ionophore A23187 from cells in the bronchoalveolar lavage (BAL) fluid of atopic asthma tics was significantly lower in the subgroup with steroid-dependent in tractable asthma (SDIA) than in non-SDIA patients (p < 0.05). In contr ast, histamine release in nonatopic SDIA patients did not differ from nonatopic non-SDIA patients. The release of leukotriene C-4 (LTC(4)) w as significantly lower in atopic patients with SDIA (p < 0.02). Howeve r, there was no significant difference in LTC(4) release between nonat opic patients with SDIA and without SDIA. The proportion of BAL lympho cytes was significantly lower in atopic patients with SDIA than in tho se without it (p < 0.05), although there was no significant difference between the nonatopic patients with and without SDIA. These results s how that glucocorticoids affect humoral and cellular events in the air ways of atopic asthmatics more than in those of nonatopic asthmatics.