We experienced two cases of occupational asthma induced by Elk dander in Elk-feeders and confirmed these cases by the bronchial provocation test with Elk dander. Both of them showed dual asthmatic response. They also showed positive reaction to the skin prick test with EIK dander. Now one of them has no asthmatic symptoms at all after complete avoidnce of EIK dander.
Asthma, Occupational* ; Bronchial Provocation Tests ; Dander ; Skin

Through the study of 73 asthma patients of two male and female groups found that: The respiratory function in bronchial asthma is normal, although showings VC, FVC, FEV1, FEV1% and some other normal showings but V75 are reduced (in male group). In bronchial asthma of female, the distance within maximum breath out even in group diagnosed is normal ventilating function, it also reduced clearly by 58.77% of theory number. All showings on flow are reduced. In bronchial asthma, two showings PEF and V75 are ones for evaluating soon the obstructed ventilating disorder in bronchial asthma
Bronchial asthma

BACKGROUND: The purpose of the present study was to determine the protective effect of antiasthmatic activity of inhaled heparin, cromolyn sodium, budesonide, furosemide in exercise-induced asthma(EIA). The other important considerable point of this study was the mechanism of bronchoconstriction on EIA. METHOD: Eight subjects with a history of EIA were studied on 5 different experiment days. After obtaining baseline FEV(1) and FVC, subjects performed a standardized exercise challenge. EIA was assessed by measurement of FEV(1) before and after exercise. On experiment day 4, the exercise challengs was performed after the subjects inhaled either heparin (1,000 units/kg/day for 5 days), furosemide (1 mg/kg for 5 days), cromolyn(4 mg/kg for 5 days), or budesonide (400 micrograms/day for 5 days). On experiment day 5, the methacholine brochial provocation test was performed. On experiment day 3, activated partial thromboplastine time(aPTT) was checked. RESULTS: Maximum decrements of FEV(1)(mean+/-SE) among o to 120 minutes after exerise were as follows : heparin was 83.1+/-4.81% (p=0.010), furosemide was 80.5+/-6.87% (p=0.071), cromolyn was 86.8+/-6.53% (p=0.340), and budesonide was 79.4+/-7.31% (p=0.095). Above medications were copmpared to the control value (72.5+/-18.2%) by paired t-test. No medications had effect on PD of methacholine bronchial provocation test. The results were control (1.58+/-0.49 mumol), heparin(4.17+/-1.96 mumol), forosemide (1.85+/-0.86 mumol), cromolyn (2.19+/-0.89 mumol) and budesonide (3.38+/-1.77 mumol), respectively(p>0.05). The inhaled heparin had no effect of anticoagulation. CONCLUSION: These data demonstrate that inhaled heparin has a protective effect on EIA. The effect of inhaled cromolyn was statisitically absent with manufacture's recommended dosage on EIA. So, the dosage of cromolyn should be carefully evaluated in future. Although inhalation of budesonide and furosemide have no statistical significance compared to control, these drugs also have some protective effects on EIA.
Asthma, Exercise-Induced* ; Bronchial Provocation Tests ; Bronchoconstriction ; Budesonide* ; Cromolyn Sodium* ; Furosemide* ; Heparin* ; Inhalation ; Methacholine Chloride ; Thromboplastin

PURPOSE: Cysteinyl leukotrienes are important proinflammatory mediators in asthma. Recently, it was suggested that a promoter polymorphism in the genes encoding for leukotriene C4 synthase (LTC4S), a key enzyme in the leukotriene synthetic pathway, and cysteinyl leukotriene receptor 1 (CysLTR1) might be associated with aspirin-intolerant asthma. We investigated whether polymorphisms in LTC4S and CysLTR1 genes or their interactions were associated with the asthma phenotype, lung function, or bronchial hyperreactivity (BHR) in Korean children. METHODS: A total of 856 asthmatic children and 254 non-asthmatic controls were enrolled; a skin prick test, lung function test and bronchial provocation test were performed. Of those enrolled, 395 children underwent exercise challenge tests. The LTC4S A(-444)C and CysLTR1 T(+927)C were genotyped by polymerase chain reaction-restriction fragment length polymorphism analysis. RESULTS: Of those enrolled, 699 children were classified as having atopic asthma and 277 children, as having exercise-induced asthma (EIA). LTC4S and CysLTR1 polymorphisms were not associated with atopic asthma, EIA, or asthma per se. Lung function and BHR were not significantly different between the wild type (AA or TT) and the variant (AC+CC or TC+CC) genotypes in asthmatics, atopic asthmatics, and EIA (+) asthmatics, while total eosinophil counts were higher in the variant type of LTC4S than in the wild type in atopic asthmatics. There were no associations between the gene-gene interactions of LTC4S and CysLTR1 genotypes and the asthma phenotypes. CONCLUSION: LTC4S A(-444)C and CysLTR1 T(+927)C polymorphisms and their gene-gene interactions are not associated with asthma phenotype, lung function, or BHR in Korean children.
Asthma ; Asthma, Exercise-Induced ; Bronchial Hyperreactivity ; Bronchial Provocation Tests ; Child ; Eosinophils ; Genotype ; Humans ; Leukotriene C4 ; Leukotrienes ; Lung ; Phenotype ; Receptors, Leukotriene ; Respiratory Function Tests ; Skin

PURPOSE: Exercise-induced bronchospasm (EIB) is widely prevalent in asthmatic patients. Recently, eosinophilic airway inflammation and atopy (defined as skin sensitivity to common aeroallergens) are considered to be a important factors in the pathogenesis of asthma. Thus we studied to find out the effect of atopy and airway eosinophilic inflammation on exercise- induced bronchospasm. METHODS: We followed up the cases of 132 mild asthmatics for 2 years. On their first visit, skin prick tests, with 29 common allergens including dust mites antigen, and sputum induction were performed. And 3 days later, methacholine challenge was done. 24 hours after methacholine challenge, treadmill test was performed and the positive EIB was defined as a 15% reduction or more in FEV1 from baseline after exercise. RESULTS: EIB was observed in 54 (40.9%) of 132 asthmatic subjects. There was no significant difference in atopy between EIB positive and EIB negative asthmatics. Eosinophil and eosinophil cationic protein in induced sputum were significantly higher in EIB positive asthmatics. We also found the significant correlation between bronchial responsiveness (BR) index and maximal % fall in FEV1. CONCLUSION: The severity of bronchospasm evoked by exercise was more closely related to eosinophilic airway inflammation and airway hyperresponsiveness to methacholine than atopy.
Allergens ; Asthma ; Asthma, Exercise-Induced* ; Bronchial Spasm ; Dust ; Eosinophil Cationic Protein ; Eosinophils* ; Exercise Test ; Humans ; Inflammation* ; Methacholine Chloride ; Mites ; Skin ; Sputum

PURPOSE: Leukotriene receptor antagonists (LTRAs) are used to treat aspirin-intolerant asthma (AIA); however, the protective effects of long-term LTRA administration against aspirin-induced bronchospasm have not been evaluated. OBJECTIVES: We investigated the efficacy of a 12-week treatment with a LTRA in protecting against aspirin-induced asthma in AIA patients. METHODS: Fifty-two adult patients with AIA underwent an aspirin challenge test just before administration of montelukast (10 mg/day) and just after 12 weeks of treatment. The protective effect was assessed as the disappearance of aspirin-induced bronchospasm after 12 weeks of treatment. The results were compared according to the patients' clinical and physiological parameters. RESULTS: The decline in FEV1 following aspirin challenge was significantly reduced from 28.6+/-1.9% to 10.2+/-1.7% (P=0.0001) after 12 weeks of montelukast treatment. However, 14 subjects (30%) still showed a positive response (>15% decline in FEV1) to aspirin challenge. Grouping the subjects into good and poor responders according to post-treatment responses revealed that the pretreatment aspirin-induced FEV1 decline was significantly greater in the poor responders and that the triggering dose of aspirin and the induction time for a positive response were lower and shorter, respectively, in the poor responders. Histories of aspirin hypersensitivity and sinusitis were more prevalent among the poor responders than among the good responders. CONCLUSIONS: Twelve weeks of treatment with montelukast protected against aspirin-induced bronchospasm in 70% of the AIA cases. A poor response was associated with more severe aspirin-induced bronchospasms before treatment and a history of aspirin hypersensitivity or sinusitis. CLINICAL IMPLICATIONS: A severe response to aspirin challenge may be a predictor of poor responsiveness to leukotriene antagonist treatment.
Acetates ; Adult ; Aspirin ; Asthma ; Asthma, Aspirin-Induced ; Bronchial Spasm ; Eosinophils ; Humans ; Hypersensitivity ; Leukotriene Antagonists ; Quinolines ; Receptors, Leukotriene ; Sinusitis

BACKGROUND: While aspirin sensitivity has been known to be common among patients with severe asthma, its frequency among asthmatics with mild to moderate severity remains to be learned. OBJECTIVES: To elucidate the frequency of aspirin sensitivity and its clinical characteristics among asthma patients with mild to moderate severity. MATERIAL AND METHODS: A total of 96 asthmatics with mild to moderate severity were enrolled. They underwent lysine-aspirin and methacholine bronchial provocation tests, and gave their induced sputum after the lysine-aspirin challenge. RESULTS: FEV1 declined greater than 20% compared with baseline FEV1 in 11 of 96 patients on the lysine-aspirin challenge. The frequency of aspirin sensitivity was higher among patients with enhanced bronchial hyperresponsiveness to methacholine (PC20 < 1 mg/ml) than among those without it (27.3% vs. 6.8%). The frequency was also higher in those with induced sputum eosinophil count higher than 3% than among those without it (38.9% vs. 0%). However, it was not associated with other risk factors such as age, sex, atopy, nasal polyps, and rhinosinusitis. CONCLUSION: More than 10% of mild to moderate asthmatics have aspirin sensitivity even though they have experienced no history of aspirin sensitivity which may be related with bronchial hyperresponsiveness to methacholine and eosinophil activation.
Aspirin* ; Asthma ; Asthma, Aspirin-Induced ; Bronchial Provocation Tests ; Eosinophils ; Humans ; Methacholine Chloride ; Nasal Polyps ; Prevalence* ; Risk Factors ; Sputum

PURPOSE: Occupational asthma may be induced by high- or low-molecular weight allergens (HMWA or LMWA, respectively). The study was conducted to compare the pattern of bronchial response in 200 HMWA-induced asthmatics (n = 130) and LMWA-induced asthmatics (n = 70). METHODS: The study participants underwent a single-blind, placebo-controlled specific inhalation challenge (SIC) with workplace allergens, accompanied by evaluation of non-specific bronchial hyperresponsiveness (NSBHR) with methacholine before and after the SIC. RESULTS: A single early bronchial response more frequently occurred in HMWA-induced asthmatics than in LMWA-induced asthmatics (86.2% vs. 20%). An isolated late bronchial response or atypical patterns were more frequently observed in LMWA-induced asthmatics than in LMWA-induced asthmatics (45.7% vs. 3.8% or 34.3% vs. 10%, respectively). Baseline NSBHR before SIC was more often detected in LMWA-induced asthmatics than in HMWA-induced asthmatics (81.4% vs. 54.6%), and the median value of the provocation concentration of methacholine was relevantly lower in these patients before and after SIC. A significant 3-fold increase in NSBHR after SIC was observed more often in LMWA-induced asthmatics than in HMWA-induced asthmatics (82.8% vs. 66.1%). In addition, compared to LMWA-induced asthmatics, HMWA-induced asthmatics were older, were more frequently active smokers, showed lower level of NSBHR, and more frequently continued their work in harmful occupational exposure. CONCLUSIONS: The results of this study suggest that HMWA-induced asthmatics may have milder clinical courses and that there is a possibility of job continuation despite asthma exacerbation requiring medical surveillance.
Allergens ; Asthma ; Asthma, Occupational ; Bronchial Hyperreactivity ; Humans ; Immunoglobulin E ; Inhalation ; Methacholine Chloride ; Molecular Weight ; Occupational Exposure ; Prognosis

BACKGROUND: Altered airway mucosal osmolarity is an underlying mechanism of bronchoconstrictive response to both exercise and hypertonic saline (HS). The purpose of this study was to examine whether the osmotic challenge test using HS could predict the exercise-induced bronchospasm (EIB) in asthma. METHODS: Thirty-six consecutive young male patients with asthma visited Chonnam National Univertisy Hospital underwent bronchial challenge tests using 4.5% HS, exercise (>24 hours later), and methacholine (MCh). The relationship in the responses between HS and exercise was observed in comparison with that between MCh and exercise. RESULTS: The maximal fall in forced expiratory volume in one second following exercise was significantly higher in the HS-responders (n=19) than that in the HS-nonresponders (n=17)(35.9 +/- 4.1% vs. 17.9 +/- 2.7%, p<0.001). There was a significant correlation between the severity of EIB and HS-airway hyperresponsiveness (AHR). Compared with the MCh-AHR test in diagnosing for EIB, the HS-AHR test showed a higher specificity (71.4% vs. 42.9%), but a lower sensitivity (58.6% vs. 89.7%) and a lower negative predictive value (29.4% vs. 50.0%). At the cutoff value for moderate AHR, the MCh-AHR test had specificity comparable with and predictive values higher than those of the HS-AHR test. CONCLUSION: The HS-AHR test was more specific than the MCh-AHR test, but less sensitive and had poor negative predictive value precluding from use of it as a screening test for EIB. The MCh-AHR test at the cutoff value for moderate AHR may be more useful in predicting EIB in asthma.
Asthma ; Asthma, Exercise-Induced ; Bronchial Provocation Tests ; Bronchoconstriction* ; Forced Expiratory Volume ; Humans ; Jeollanam-do ; Male ; Mass Screening ; Methacholine Chloride ; Osmolar Concentration ; Sensitivity and Specificity

Exercise induced asthma (EIA) is defined as acute, reversible, usually self-limiting airway obstruction which develop after strenous exercise in patients with asthma. EIA is a bigger problem in children than adults due to more active and smaller airways which obstruct more easily when bronchospasm develops. The exercise elicited many change in pulmonary function of asthmatic children. These change could be measured by measurements of PEFR, FEV1, FVC, or SRaw. The propose of this study is to determine the changes and sensitivity of different pulmonary function test in asthmatic children. 37 asthmatic children exercised on free running and pulmonary function tests were performed before and every 5 minutes during 15 minutes after exercise. The results were as follows. 1) In 37 asthmatic children, EIA developed in 23 children (62%) and did not developed in 14 children (38%). The difference in sex, height, weight, total eosinophil count, serum IgF and test between EIA and Non-EIA were not significant (P>0.05). 2) In EIA group, %PEFR was changed from 109.56% to 83.56%, But in Non-EIA group, %PEFR was not changed before and after exercise loading test. 3) In EIA group, %FEV1 was changed from 90.91% to 74.87%. But in Non-EIA group, %FEV1 was not changed before and after exercise loading test. 4) In EIA group, %FVC changed from 91.83% to 75.35%. But in Non-EIA group, %FVC was not change before and after exercise loading test. 5) There was significant difference in pre-exercise specific airway resistance between EIA (6.7+/-1.7) and normal children (5.8+/-2.2)(p<0.05). In EIA group, %SRaw was changed from 115.7% to 161.2%. But in Non-EIA group, %SRaw was not changed before and after exercise loading test. 6) During the post-exercise observation period, increasement of SRaw was greater than changes in any other pulmonary function test. SRaw is the most sensitive test for the ditection of exercise induced airway obstruction is asthmatic children.
Adult ; Airway Obstruction ; Airway Resistance* ; Asthma ; Asthma, Exercise-Induced ; Bronchial Spasm ; Child* ; Eosinophils ; Humans ; Peak Expiratory Flow Rate ; Respiratory Function Tests ; Running