気管支肺胞洗浄液中リンパ球増多と患者年齢およびIgE系アレルギー反応との関連について

The proportion and number of lymphocytes in the airways were analyzed in 15 patients with a high proportion of lymphocytes in bronchoalveolar lavage (BAL) fluid (more than 30%) and in 17 patients with less than 20% of BAL lymphocytes. 1. Both atopic and nonatopic asthma patients with a high proportion of BAL lymphocytes were aged more than 50 years. In contrast, the age of patients with less than 20% of BAL lymphocytes ranged widely, from 29 to 63 years, in the two asthma types. 2. Age at onset of the disease, serum IgE levels, and ventilatory function test were not related to the proportion of BAL lymphocytes. 3. In patients with a high proportion of BAL lymphocytes, the mean proportion of these cells was 47.3% in atopic patients and 36.4% in non-atopic patients, i. e., there was no significant difference between the two asthma types. The absolute number of BAL lymphocytes in these patients was significantly higher in atopic (5.62×10(6)) than in nonatopic asthma (0.77×10(6)) (p<0.01). These findings show that an increased number of lymphocytes in the airways is clearly related to patient age and IgE-mediated allergic reaction.気管支肺胞洗浄(BAL)液中のリンパ球頻度が30%以上の15例および20%以下の17例の気管支喘息患者を対象に,BAL液中リンパ球頻度と年齢およびIgE系反応との関連について検討を加えた｡1.BALリンパ球が高頻度(30%以上)を示す症例は,アトピー型,非アトピー型を問わず,50才以上の年齢層に多い傾向が見られた｡一方,BALリンパ球20%以下の症例の年齢は,29-63才まで幅広く分布していた｡2.発症年齢,血清IgE値,換気機能とBAL液中リンパ球頻度との間には関連は見られなかった｡3.BAL液中リンパ球頻度が高い症例では,アトピー型では平均リンパ球頻度は47.3%,非アトピー型では36.4%であったが,両群間には有意の差は見られなかった｡しかし,BAL液中のリンパ球の絶対数は,アトピー型(5.62×10(6))において,非アトピー型(0.77×10(6)) に比べ有意に高い値を示した(p<0.01)。これらの結果は,気道内リンパ球の増加は,患者年齢とIgE系反応と密接に関連していることを示唆している

On climatology in Misasa spa (thirteenth report)

われわれは1956年以降，三朝温泉地の気候要素について観測を行ってきているが，今回は第13報として，ひきつづき1989年1月1日から1989年12月末日までの1ヵ年の気象観測の資料を報告することとした。なお1985年4月1日以降は自動記録装置が備えられたので，今回の資料はすべてこの自動記録装置によるものである。Climatological data of the last 12 months (1989.1.1-1989.12.31) obtained by the climate autorecording system at the Misasa Medical Branch in Misasa spa, Tottoriken, Japan, are presented

カンジダ特異的IgG(4)抗体と気管支喘息

Serum levels of Candida-specific IgG(4) antibodies were examined in 66 patients with bronchial asthma, relating to patient age and asthma severity. 1. The levels of Candida-specific IgG(4) antibodies were the highest in patients with 60+years of age, compared to the levels in cases with 0-39 and 40-59 years of age. 2. In cases with 40-59 years of age, the levels of Candida-specific IgG(4) were significantly higher in cases with long-term steroid therapy (severe intractable asthma) than in cases without steroid regimen. The results suggest that increased levels of Candida-specific IgG(4) were observed in relation to patient age and asthma severity.66例の気管支喘息症例を対象に，血清中カンジダ特異的lgG(4)抗体を測定し，その血中レベルと年齢および喘息の重症度との関連について検討を加えた。1．血清カンジダ特異的IgG(4)値は，0～39才，40～59才の年齢層にくらべ，60才以上の年齢層において高く，年齢によりその値が変動することが 示唆された。2．40～59才の年齢層では，血清カンジダ特異的IgG(4)は，ステロイド非使用例にくらべ，ステロイド依存性重症難治性喘息症例で有意の高値を示し，この年齢層では，カンジダ特異的IgG(4)抗体がその発症病態に関連している可能性が示唆された。以上，カンジダ特異的IgG(4)抗体の上昇は，高年齢層の症例（60才以上）では全般的に，また40～59才の年齢層で重症型喘息症例において観察されることが明らかにされた

気管支喘息患者における細胞性免疫,ガンジダ抗原に対する遅延型反応の抑制

Delayed cutaneous hypersensitivity towards Candida albicans was examined　in 200 patients with bronchial asthma in relation to patient age and the level of　total IgE. 1. Delayed skin reactivity towards C.albicans was depressed in the patients between the ages of 10 and 20 and in those over the age of 61. A significant difference was present in delayed skin reactivity between the groups of 10-20 and 41-50 years old. 2. The frequency of the patients with positive delayed skin reactivity towards C.albicans was the highest in those with low levels of total IgE (0 -100 IU/ml) and the low est in those with high levels of total IgE (over than 1001 IU/ml). The results suggest that cell-mediated immunity towards C.albicans is depressed re lating to atopics in the patients between 10 and 20 and to aging in the patients over 61.気管支喘息200例を対象にカンジダに対する即時型および遅延型皮膚反応を観察し,これらの皮膚反応と年令,血清IgE値との関連について検討を加えた｡1. カンジダに対する遅延型皮膚反応は,10～20才の年齢層および61才以上の年齢層の症例において,その陽性率の低下が観察された｡そして,10～20才の年齢層と41～50才の年齢層の症例では,両者間で陽性率の有意の差が見られた(p<0.001)。2. カンジダに対する遅延型皮膚反応の陽性率は,血清IgE値が低い(0～100 IU/ml)症例において最も高く,一方血清IgE値が高い(1001IU/ml以上)症例において最も低いという傾向が見られた｡これらの結果は,カンジダに対する細胞性免疫は,10～20才の年齢層ではアトピーと,また61才以上の年齢層では加齢と関連して抑制されることを示唆するものと考えられる

気管支喘息の発症における加齢の影響について

Skin tests, serum total IgE levels, specific IgE antibodies against each allergen, bronchial reactions provoked by allergens and histamine release from basophils are well known as prameters of immediate allergic reactions. The incidence of positive immediate skin reaction to allergens such as house dust, ragweed, Aspergillus Alternaria, Cladosporium and Broncasma decreased with aging. On the other hand, the incidence of positive skin reaction to Candida albicans was higher in cases between the age of 41 and 50 and cases over the age of 61 compared to that in the other groups classified by age. Serum IgE levels was highest in cases aged between 0 and 30. The levels of serum IgE decreased with aging. The incidence of positive RAST scores (more than 2+) and positive bronchial reaction to house dust were highest in cases between 0 and 30, and decreased with aging. However, the positive ratio of these tests against C. albicans were highest in cases between 41 and 50. The degree of histamine release from basophils of asthmatics induced by anti-IgE was consistently high without any correlation to aging when their serum IgE levels were more than 501 IU/ml. In the cases with serum IgE levels of less than 300 IU/ml, basophil reactivity to anti-IgE decreasd with aging. Basophil reactivity to house dust was generally dependent on the levels of specific IgE antibodies against the allergen. Although basophil reactivity to C. albicans was also high in cases with positive RAST scores, some cases with a RAST score of 0+ or 1+ showed high or moderate basophil reactivity. Moderate or high reactivity of basophils was frequently observed in cases between 41 and 50 and cases over age 61.気管支喘息の発症機序の一つとして,IgE抗体にmediateされる即時型アレルギー反応や好塩基球の反応性の関与が明らかにされている｡本論文では,即時型アレルギー反応や抗ヒトIgEや特異抗原に対する好塩基球の反応性が加齢によりどのような影響を受けるかについて検討を加えた｡ハウスダスト,ブタクサ,アスペルギルス,アルテルナリア,クラドスポリウム,ブロンカスマ などによる皮内反応の陽性率は,加齢とともに低下する傾向を示した｡一方カンジダによる皮内反応の陽性率は,41～50歳および61歳以上の年齢層で高度であった｡血清IgE値は加齢とともに低下する傾向がみられた｡ハウスダスト特異的IgE抗体,吸入誘発試験の陽性率は,加齢とともに低下する傾向を示した｡一方カンジダでは特異的IgE抗体,吸入誘発試験いずれも41～50歳および61歳以上の年齢層で比較的高い陽性率が観察された｡抗ヒトIgEに対する好塩基球の反応性は,血清IgEが高値(501IU/ml以上)の場合は年齢と関係なくIgE依存性であったが,血清IgE値の低い症例(301IU/ml以下)では年齢が高い群でその反応性が低い症例の比率が大きかった｡ハウスダストに対する好塩基球の反応性は,抗ヒトIgE同様年齢が高い群ほど反応性が低い症例の比率が大きかった｡カンジダに対する好塩基球の反応性は,41～50歳および61歳以上の年齢層の症例でより高度であった

気管支喘息における気道内への好酸球の出現とその意義. 過分泌と関連して.

A correlation between the proportion of eosinophils in bronochoalveolar lavage (BAL) fluid and amount of expectoration was examined in patients with atopic asthma. The subjects were divided into two groups : cases with high proportion (20% of more) (group A) and low proportion (less than 5%) (group B) of eosinophils in the BAL fluid. Any significant difference was not paesent in the value of each ventilatory parameter between the two groups. The amount of expectoration/day was significantly higher in group A compared with group B (p<0.001). These results suggest that eosinophilia in BAL fluid correlates to mucus hypersecretion in the airways of patients with atopic asthma.アトピー型気管支喘息のなかから,気管支肺胞洗浄液(BALF)中の好酸球の出現頻度が20%以上の症例(グループA)と5%以下の症例(グループB)の2群を選び出し,それぞれの換気機能および喀痰量を比較検討した｡その結果,換気機能には両群間に有意の差は見られなかったが,1日喀痰量は,BALF中好酸球の著明増多を示すグループAにおいて有意に多い傾向が見られた｡これらの結果は,BALF中好酸球増多と過分泌との間にはある程度の関連があることを示しているものと考えられた

抗原および抗ヒトIgEに対する抗塩基球の反応性. 3.Ca2(+)の細胞内流入およびヒスタミン遊離

The release mechanism of chemical mediators from basophils and mast cells was discussed when these cells were stimulated by different antigens and anti-IgE. 1. Ca(2+) influx into mast cells increased after stimulation by antigen. The increased Ca(2+) uptake by mast cells was inhibited by antiallergic agents, disodium cromoglycate (DSCG) and tranilast, and calcium antagonists, nifedipine and nicardipine. 2. The dose-response curve of histamine release by antigen was different from that by anti-IgE. The maximum release of histamine by house dust was, however, similar to that by anti-IgE. House dust- and anti-IgE-induced release of histamine increased with higher- serum IgE levels. On the contrary, the release of histamine by Candida albicans was not releated to serum IgE levels, and the release by C. albicans did not parallel therelease by anti-IgE.ハウスダスト,カンジダなどの抗原および抗ヒトIgE刺激時の,抗塩基球および肥満細胞からの化学伝達物質遊離機序について,若干の検討を行った｡1.肥満細胞へのCa(2+)の流入は,抗原刺激後に増加する傾向を示した｡この肥満細胞のCa(2+)取り込みの増加は,抗アレルギー剤であるクロモリン(DSCG)やトラニラストやCa(2+)拮抗剤であるニフェジピンやニカルジピンによって抑制された｡2.抗原(ハウスダスト)によるヒスタミン遊離の濃度依存性カーブは,抗ヒトIgEによるカーブとは異なっていた｡しかし,ハウスダストが抗原である症例では,抗原による最高ヒスタミン遊離値は,抗ヒトIgEによる遊離値とある程度の相関を示した｡そして,抗原(ハウスダスト)および抗ヒトIgEによる好塩基球からのヒスタミン遊離は,血清IgE値が上昇するにつれて,増加する傾向が見られた｡一方,カンジダによるヒスタミン遊離は,血清IgE値との相関は無く,また,抗ヒトIgEによるヒスタミン遊離との間にも関連は見られなかった

好塩基球からのヒスタミン遊離に関する研究. 1 自動分析装置による全血からのヒスタミン遊離の測定

Histamine released from whole blood was determined by an automated fiuorometric histamine analysis system. The increased release of histamine from basophils by anti-IgE was observed in ten healthy subjects and 12 extrinsic asthma patients, while the release in 11 intrinsic asthma patients was significantly less as compared to that in healthy and extrinsic asthma subjects. House dust extract caused a significant increase in the histamine release from basophils of the extrinsic asthma patients who are sensitive to house dust. It was concluded from this study that histamine released from basophils could be easily determined by an automated analysis system and that the method is useful for the diagnosis and study of allergy.ヒスタミン自動分析装置により,健康人10名,気管支喘息23例の全血からのヒスタミン遊離を測定した. 抗ヒトIgEを添加した際のヒスタミン遊離は,健康人および外因性気管支喘息症例では有意の増加傾向を示したが,一方内因性喘息症例では遊離増加はほとんどみられなかった. ハウスダスト抗原添加では,ハウスダストが抗原である気管支喘息症例においてのみ全血からの有意のヒスタミン遊離の増加が観察された. 以上の結果より,ヒスタミン自動分析装置による全血からの遊離ヒスタミンの測定は,気管支喘息の病態解明の1手段として極めて有用であると考えられる

Comparison of basophil histamine release induced by the cross-linking of IgE receptors.

Basophil histamine release induced by allergens (house dust and Candida albicans) and anti-IgE was examined in 31 patients with bronchial asthma in relation to patient age, age at onset of the disease and serum IgE levels. Basophils from patients under 40 years of age generally released a significantly large amount of histamine by stimulation with house dust and anti-IgE. On the other hand, histamine release from patients over 41 years of age was generally not marked when the cells were incubated with house dust and anti-IgE, although, in some cases, the release induced by C. albicans was fairly marked. Basophils from patients under 30 years of age at onset were reactive to house dust and anti-IgE, while the cells from patients over 41 years of age at onset tended to be reactive only to C. albicans. Basophils from patients with low serum IgE levels were less reactive than the cells from patients with high levels of IgE to house dust and anti-IgE. C. albicans-induced release of histamine did not correlate with serum IgE levels.</p

Atopic asthma in patients of middle or advanced age

中高年令（41才以上）のアトピー型喘息患者の特徴を明らかにするために，アトピー型喘息患者88例を0～20才，21～40才，41～60才，61才以上の各年令別に分け，年令，性別，発症年令，既往歴，家族歴，末梢血好酸球，血清IgE値，皮内反応の各項目について検討を加えた。結果は，中高年のアトピー型喘息患者は1）その年代の全喘息患者に占める割合は低く，2）男性が多く，3）平均発症年令は高く，4）その他のアレルギー性疾患の既往歴を持たない症例が比較的多く，5）皮内反応では，ハウスダスト陽性率が比較的低く，カンジダ，アスペルギルスの陽性率は比較的高い傾向にあった。6）家族歴，末梢血好酸球，血清IgE値では，明らかな傾向は認められなかった。In order to elucidate the characteristics of atopic asthma in patients of middle or advanced age (over 41 years old), 88 atopic asthmatic patients were divided into 4 groups according to their ages, 0～20, 21～40, 41～60 and over 61 years old, and age, sex, age of onset, past history, family history, number of peripheral eosinophils, serum IgE and skin test were compared among these groups. The results were as follows: Atopic ashmatic patients of middle or advanced age were 1) less frequent in all asthmatic patients of same age group, 2) more frequent in males than in females, 3) higher in averaged age of onset, 4) more frequent in cases without other allergic past histories, 5) less frequently positive to house dust and more frequently positive to Candida and Aspergillus in skin test, 6) not different in family history, number of peripheral eosinophils and serum IgE compared to other groups