engleski

Extremely altered non-specific bronchial reactivity in a moderate asthmatic patient after nasal challenge

JR, male, 40yrs, nonsmoker, 16 yrs of occupational exposure to organic solvents, acrylates and diisocyanates as a car painter. Has a moderate asthma for a year. Asthma attacks induced by exercise and occupational exposure. Has also the symptoms of conjuctivitis and rhinitis. Th. salbutamol MDI. Has a negative family history for asthma or atopy. Positive skin prick test to Dermatophagoides pt.- negative (<0,35kU/L). Nonspecific bronchial reactivity on three separate occasions PC20FEV1 from 0,125 to 0,5 mg/ml of histamine. Nonspecific nasal reactivity PC75NAR=4 mg/ml of histamine. Nonspecific bronchial reactivity measured on two separate occasions after nasal chalenge was significantly altered to PC75FEV1=4 mg/ml of histamine. We discuss the mechanism of such alteration in view of the results of our previous studies which show that it is probably mediated via reflex activation of presinaptic beta2-receptors in bronchi. In this patient pre-existing blockage of M2 muscarinic receptors by eosinophil mediators (MBP, EPO) could enhance the alteration of bronchial reactivity seen in healthy subjects.

Occupational; rhinitis; asthma; bronchial provocation; nonspecific bronchial responsiveness; nasal provocation; histamine

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