CHANGES IN THE PROPORTIONS OF BRONCHOALVEOLAR LYMPHOCYTES, NEUTROPHILS AND BASOPHILIC CELLS AND THE RELEASE OF HISTAMINE AND LEUKOTRIENES FROM BRONCHOALVEOLAR CELLS IN PATIENTS WITH STEROID-DEPENDENT INTRACTABLE ASTHMA

The proportion of inflammatory cells in bronchoalveolar lavage (BAL) f luid and the release of chemical mediators from BAL and peripheral blo od cells were examined in 40 patients with steroid-dependent intractab le asthma (SDIA) to clarify the effects of a long-term glucocorticoid regimen on these cells. The proportion of BAL lymphocytes was signific antly reduced (p < 0.01) and the proportion of BAL neutrophils was sig nificantly increased (p < 0.01) in SDIA patients compared with non-SDI A patients. The proportion of basophilic cells (mast cells and basophi ls) in BAL fluid was significantly lower in SDIA patients compared to non-SDIA patients (p < 0.02). The values of six ventilatory parameters were significantly lower in SDIA patients with a high proportion of B AL neutrophils (more than 10%) compared with the values in non-SDIA pa tients. The release of histamine and leukotriene C4 (LTC4) from the BA L cells of patients with atopic asthma was significantly reduced in SD IA patients compared with non-SDIA patients (p < 0.05). These results show that the changes in the proportion of BAL cells are observed in p atients with SDIA, and these changes are related to suppressed ventila tory function and a reduction in the release of histamine and LTC from BAL cells.