IgE-mediated and age-related bronchial hyperresponsiveness in patients with asthma. relationship to family history of the disease.
OBJECTIVE
to uncover any differences in the age-related and IgE-mediated pathophysiology of the airways in asthmatics.


METHODS
we examined the relationship of both IgE-mediated bronchial hyperresponsiveness and the cell content of bronchoalveolar lavage fluid with a family history of asthma in 263 patients with asthma classified according to age at onset.


RESULTS
bronchial hyperresponsiveness decreased significantly as age at onset increased in those without a family history. Responsiveness was significantly higher in patients who were > or = 60 years of age at onset who had a family history than in those who did not (P < 0.05). The proportion of lymphocytes in bronchoalveolar lavage fluid was significantly higher in patients between 50 and 59 years old at onset who had a family history than those who did not (P < 0.05). These results suggest that bronchial hyperresponsiveness and the proportion of bronchoalveolar lavage lymphocytes differ according to the presence or absence of a family history, a finding which is closely related to IgE-mediated allergy in elderly patients at onset.


CONCLUSIONS
our findings suggest (i) the possibility of asthma induced by non-IgE-mediated allergy in elderly patients and (ii) that bronchial responsiveness is also influenced by IgE-mediated allergy and age at onset.
Mitsunobu
F
F
Department of Medicine, Okayama University Medical School, Tottori, Misasa, Japan. fumin@ccews2.cc.okayama-u.ac.jp
Mifune
T
T
Hosaki
Y
Y
Ashida
K
K
Tsugeno
H
H
Okamoto
M
M
Harada
S
S
Tanizaki
Y
Y
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001249:Asthma / Q000235:genetics / Q000276:immunology* / Q000503:physiopathology; D016535:Bronchial Hyperreactivity / Q000276:immunology*; D001992:Bronchoalveolar Lavage Fluid / Q000166:cytology; D004804:Eosinophils / Q000166:cytology; D005260:Female; D030342:Genetic Diseases, Inborn / Q000235:genetics / Q000276:immunology / Q000503:physiopathology; D006801:Humans; D007073:Immunoglobulin E / Q000276:immunology*; D007958:Leukocyte Count; D008214:Lymphocytes / Q000166:cytology; D008264:Macrophages / Q000166:cytology; D008297:Male; D008875:Middle Aged; D009504:Neutrophils / Q000166:cytology
D007073:Immunoglobulin E