Repeated inhalation of low doses of cat allergen that do not induce clinical symptoms increases bronchial hyperresponsiveness and eosinophil cationicprotein levels
F. De Blay et al., Repeated inhalation of low doses of cat allergen that do not induce clinical symptoms increases bronchial hyperresponsiveness and eosinophil cationicprotein levels, INT A AL IM, 120(2), 1999, pp. 158-165
The aim of this study was to investigate whether repeated exposure to subcl
inical doses of cat allergens, not inducing asthma symptoms, could affect e
osinophil cationic protein (ECP) levels in bronchoalveolar lavage (BAL) or
in peripheral blood, without the appearance of clinical symptoms. Twelve pa
tients with mild asthma, all sensitized to cats and not exposed to cat alle
rgen at home, underwent a series of inhalations of cat allergen or placebo
for 8 days over 2 weeks. A methacholine challenge was performed before and
after the allergen and saline exposures, and BAL and blood were sampled for
ECP measurements and eosinophil counts. No patients experienced asthma sym
ptoms. However, PD20 methacholine (geometric mean) decreased significantly
from 263 mu g before to 126 mu g after inhalation of allergen. Inhalation o
f saline did not induce any significant change in PD20. The change in log P
D20 before and after cat allergen exposure was statistically different from
the change in log PD20 before and after saline. Median ECP levels in BAL a
nd serum increased significantly after allergen exposure, from 0.8 to 3.1 m
u g/l (p<0.02) and from 15.9 to 31.4 mu g/l (p<0.05), respectively. No chan
ge was observed after saline inhalations. The change in BAL and serum ECP l
evels was statistically significant compared to that in the control group.
The number of eosinophils did not change, however, nor did IL-5 and RANTES
levels in BAL and serum. In conclusion, our results show that (1) exposure
of asthma patients to repeated low doses of allergen, which did not provoke
any clinical symptoms, is capable of inducing a local eosinophil activatio
n associated with an increase in nonspecific bronchial hyperresponsiveness
and (2) the increase in serum ECP levels due to eosinophil activation prece
des the occurrence of asthma symptoms and may thus be a marker of allergen
exposure in allergic asthma.