title: Delayed asthmatic response: a new phenotype of bronchial response to allergen challenge and soluble adhesion molecules in the serum.
abstract: BACKGROUND
  Patients with bronchial asthma develop various types of asthmatic response to bronchial challenge with allergen, such as immediate asthmatic response, late asthmatic response, or delayed asthmatic response (DYAR), due to different immunologic mechanisms.
  
  
  OBJECTIVE
  To investigate the appearance and possible changes in the concentrations of soluble cell adhesion molecules during the DYAR, to explore the involvement of particular cell types in the mechanism(s) leading to DYAR, and to contribute to a fuller understanding of this clinical phenomenon.
  
  
  METHODS
  The DYAR recorded in 28 patients (P < .001), appearing within 26 to 32 hours, reaching maximum within 32 to 48 hours, and resolving within 56 hours after the allergen challenge, was repeated 2 to 6 weeks later. The repeated DYAR (P < .001) was supplemented with blood cell counts and measurement of serum concentrations of soluble adhesion molecules by an enzyme-linked immunoassay.
  
  
  RESULTS
  The prechallenge concentrations of soluble intercellular adhesion molecule 1 (sICAM-1), soluble vascular cell adhesion molecule 1 (sVCAM-1), soluble platelet endothelial cell adhesion molecule (sPECAM-1), soluble E-selectin, soluble L-selectin, soluble P-selectin, and soluble E-cadherin did not differ significantly from healthy controls. The DYAR was associated with the following changes in the serum: an increase of sICAM-1 at 6 and 12 hours and a decrease at 24 hours; an increase of sVCAM-1 at 24 and 36 hours; an increase of sPECAM-1 at 36 and 48 hours and a decrease at 56 and 72 hours; an increase of soluble E-selectin at 56 hours; an increase of soluble L-selectin at 56 and 72 hours; a decrease of soluble E-cadherin at 48 and 56 hours; and increased counts of blood leukocytes at 36, 48, and 56 hours, neutrophils at 24, 36, 48, and 56 hours, lymphocytes at 24, 36, and 48 hours, and monocytes at 6, 12, and 24 hours. The Th1/Th2 ratio in blood increased at 24, 36, 48, and 56 hours. The intracellular concentration of interferon γ, but not of interleukin 4, increased at 24, 36, 48, and 56 hours.
  
  
  CONCLUSIONS
  These results provide evidence of the involvement of neutrophils, Th1 lymphocytes, monocytes, platelets, and endothelial cells, upon participation of various adhesion molecules, in mechanisms(s) underlying the clinical DYAR.
authors.affiliation: Allergy Research Foundation, Breda, The Netherlands. zpelikan@casema.nl
authors.forename: Zdenek
authors.initials: Z
authors.lastname: Pelikan
mesh_terms: D000328:Adult; D000485:Allergens / Q000276:immunology*; D001249:Asthma / Q000097:blood / Q000209:etiology* / Q000276:immunology; D001985:Bronchial Provocation Tests; D015815:Cell Adhesion Molecules / Q000097:blood / Q000502:physiology*; D005260:Female; D006801:Humans; D018799:Intercellular Adhesion Molecule-1 / Q000097:blood; D007371:Interferon-gamma / Q000097:blood; D008297:Male; D008875:Middle Aged; D009504:Neutrophils / Q000502:physiology; D010641:Phenotype; D012882:Skin Tests; D018417:Th1 Cells / Q000276:immunology; D019010:Vascular Cell Adhesion Molecule-1 / Q000097:blood
chemical_list: D000485:Allergens; D015815:Cell Adhesion Molecules; D019010:Vascular Cell Adhesion Molecule-1; D018799:Intercellular Adhesion Molecule-1; D007371:Interferon-gamma