ステロイド依存性重症難治性喘息の臨床的検討 －免疫アレルギー学的検討－

ステロイド依存性重症難治性喘息56例について免疫アレルギー学的検討を行った。その結果41才以降発症のLate　Onset　Asthmaが約半数を占め，血清IgE値が比較的低値であり，ハウスダストに対しての皮内反応，特異的IgE抗体価，ヒスタミン遊離はいずれも全般的に低く，カンジダに対しての皮内反応，特異的IgG抗体価はむしろ比較的高く，肺機能では末梢気道閉塞の傾向が窺われ，臨床分類では，気管支攣縮＋過分泌型，および細気管支閉塞型が多数を占める等の特徴を有することが明らかにされた。

Clinical studies on steroid-dependent intractable asthma were carried out in 56 patients relating to immuno-allergic aspects. 1. In most half of the patients with steroid-dependent intractable asthma, age at onset of the disease was 41 years old or over (so-called "Late Onset Asthma"). 2. The frequency of positive skin reaction for house dust was relatively low. whereas that for Candida was relatively high. 3. The serum IgE concentrations of these patients were in general low. Many patients showed low serum IgE concentrations of less than 300IU/ml. The concentrations of specific IgE antibodies for house dust and Candida albicans were also low. 4. The concentrations of specific IgG antibodies for Candida albicans were high compared to those for house dust. 5. Basophil histamine release induced by house dust and Candida albicans was not so remarkable in majoriy of these patients, while anti-IgE-induced histamine release from basophils ranged widely. 6. In these patients, small airway obstruction was suggested in ventilatory function test. 7. In clinical classificatin of asthma, type Ⅰa; bronchospasm type was a few, while type Ⅰb; hypersecretion and type Ⅱ; bronchiolor obstruction type were dominant in the cases studied here.