Allergen injection therapy may improve nonallergic bronchial hyperresponsiveness, but results at the moment are less than convincing. The present study was conducted to evaluate the effect of immunotherapy on the degree of nonspecific bronchial hyperresponsiveness in patients with allergic bronchial asthma (BA) and/or allergic rhinitis (AR). Methacholine challenge bronchial provocation test, allergic skin test, serum IgE and peripheral blood eosinophil counts were performed before and after 12 months or more of immunotherapy. The improved group, as determined by a shift of at least two doubling concentrations of methacholine, was 75% of AR (n=16), 41.7% of BA (n=24) and 53.8% of BA+ AR (n=13). The geometric mean of the methacholine provocational concentration (PC20) changed from 3.40 to 14.36 mg/ml (P <0.05) in AR, from 0.73 to 1.04 mg/ml in BA (not significant), and from 1.43 to 5.07 mg/ml (P <0.05) in BA+ AR. In conclusion, nonspecific bronchial hyperresponsiveness was improved by immunotherapy in three quarters of the allergic rhinitis cases and in about a half of the allergic bronchial asthma patients, which suggests that immunotherapy might be helpful at preventing the development of bronchial hyperresponsiveness in allergic rhinitis patients, and that it does not improve bronchial hyperresponsiveness in about a half of allergic bronchial asthma patients.
Adult ; Asthma/therapy* ; Bronchial Hyperreactivity/therapy* ; Hay Fever/therapy* ; Human ; IgE/blood ; Immunotherapy* ; Methacholine Chloride/pharmacology ; Middle Age ; Rhinitis, Allergic, Perennial/therapy*

The author has made the electron microscopic study of enzymes in eosinophils in order to clearify the influence of hyposensitization in allergic rhinitis to the activity of enzymes in eosinophilic granules and the following results were obtained. 1. In all 3 control, hyposensitization and allergic groups, eosinophilic granules with matrix and crystalloid core in circulating blood and tissue was observed. 2. In all 3 groups, activity of acid phosphatase was not found in neutrophil, basophil, macrophage and glands as a form of coagulated activating colony of acid phosphatase. 3. In control and hyposensitizing groups, number of eosinophils were smaller than that was counted in allergic group. Activity of peroxidase in granule was weak and granular out flowing and rupture of cell membrane were not observed. 4. In allergic group, eosinophil count was high, activity of peroxidase in granule was strong and granular out flowing and rupture of cell membrane were severe. At the same time, many vacuoles, which were suspected to be the result of phagocyte the protein as foreign substance, wag observed. Judging from the fact that eosinophil has a specific relation to allergic diseases and the activity of peroxidase that exist as an enzyme in eosinophilic granule is strong, it is believed that the major function of eosinophil is phagocytosis of antigen, or antigen-antibody complex. On the other hand, the fact that activity of peroxidase was weak in hyposensitizing group lead us to believe that the activity of peroxidase may be used as an indicator for detecting hyposensitizing status in the treatment of allergic disease.
Acid Phosphatase/metabolism* ; Adolescent ; Adult ; Child ; Desensitization, Immunologic* ; Eosinophils/enzymology ; Eosinophils/ultrastructure* ; Female ; Hay Fever/therapy* ; Human ; Male ; Middle Age ; Peroxidases/metabolism*