title: Delayed asthmatic response to bronchial challenge with allergen-mediators, eicosanoids, eosinophil and neutrophil constituents in the blood and urine.
abstract: BACKGROUND
  In patients with allergic bronchial asthma, different immunologic mechanisms may participate and lead to different types of asthmatic response to allergen challenge, such as immediate/early (IAR/EAR), late (LAR) or delayed asthmatic response (DYAR).
  
  
  OBJECTIVE
  In 55 of 397 asthmatics, DYAR has been recorded (p < 0.001) and confirmed by repeated bronchial challenge with the same allergen (p < 0.001). DYAR began between 26 and 32 h, reached a maximum between 32 and 48 h and resolved within 56 h after the challenge. DYAR was associated with various clinical symptoms and diagnostic parameters having diverged from those recorded during the IARs/EARs and LARs.
  
  
  METHODS
  In 25 of 55 patients, repeated DYAR has been supplemented with the recording of leukotriene B(4) (LTB(4)), LTC(4), LTE(4), prostaglandin D(2) (PGD(2)), PGE(2), PGF(2)(α), thromboxane B(2), lipoxin A(4), eosinophil cationic protein, eosinophil-derived neurotoxin/eosinophil protein X, eosinophilic peroxidase, myeloperoxidase, histamine and tryptase in peripheral blood, and of LTC(4), thromboxane B(2), eosinophil-derived neurotoxin and 9α,11β-PGF(2) in urine, before and up to 72 h after the bronchial allergen challenge, by means of enzyme-linked immunoassay (ELISA/EIA) or ImmunoCAP.
  
  
  RESULTS
  DYAR was accompanied by a significant increase in the plasma concentrations of LTB(4) (p < 0.05) and myeloperoxidase (p < 0.05) at 24, 36 and 48 h after the challenge, whereas the plasma/serum or urine concentrations of the other factors did not demonstrate any significant changes (p > 0.05).
  
  
  CONCLUSIONS
  These results would indicate an active and prominent involvement of neutrophils, in addition to the previously demonstrated role of the Th1 lymphocytes, in the clinical DYAR.
authors: Allergy Research Foundation, Breda, The Netherlands. zpelikan@casema.nl
authors: Zdenek
authors: Z
authors: Pelikan
mesh_terms: D000328:Adult; D000485:Allergens / Q000276:immunology*; D001249:Asthma / Q000276:immunology* / Q000503:physiopathology; D001985:Bronchial Provocation Tests; D015777:Eicosanoids / Q000276:immunology*; D004797:Enzyme-Linked Immunosorbent Assay; D004804:Eosinophils / Q000276:immunology*; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D006968:Hypersensitivity, Delayed / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D009504:Neutrophils / Q000276:immunology*
chemical_list: D000485:Allergens; D015777:Eicosanoids