Læknablaðið : fylgirit - 01.08.2002, Page 20

ABSTRACTS / 21 ST NORDIC CONGRESS OF ALLERGOLOGY
Results: Comparing pre- and post-therapy levels, IL-10 levels
increased 15-fold and 5-fold al'ter the first and second treatment
period, respectively. TNFa levels increased 7-fold and 20-fold after
the first and second treatment period, respectively. CD14 increased
9-fold in monocytes.
Conclusion: IL-10 and TNFa levels in blood seem to increase, as
does the expression of receptors associated with inflammation
(CD14) during intravenous IgG treatment. A transient and minor
clinical improvement was observed.
P 2 - Fluticasone propionate attenuated the late
asthmatic reaction more effectively than montelukast
Bruce C, Palmqvist M, Sjöstrand M, Aronsson B, Arvidsson P,
Lotvall J
Background: Asthma is an inflammatory disease. The aim of this
study was to determine the anti-inflammatory effects of montelu-
kast (M) compared to fluticasone propionate (FP) and placebo (P).
Methods: In a randomised, double blind study, mild allergic
asthmatics with an early and late (EAR and LAR) asthmatic
reaction after bronchial allergen challenge participated. Treatments
with FP 250pg x 2, M 10 mg x 1 or P was given for 8 days. On day 7
a bronchial allergen challenge was done. After 7 and 24 hours a
sputum induction was performed. A methacholine challenge was
done after 24 hours.
Results: 8 patients (6 allergic to cat, 1 birch, 1 horse) participated.
Their mean baseline FEV, was 92% pred (67-104%). At screening
thr max FEV|-fall during the EAR (0-lh) was 28% (20-42%) and
during the LAR (3-7h) 28% (16-56%). After M the max FEVrfall
during EAR was 12%±6.4 (SD), compared to after FP 18%±8.8
(SD), p=0.05. The max fall in FEV! during the LAR was signifi-
cantly attenuated after FP, 3%±4.9 (SD), compared to after M,
14%±13.6 (SD), p=0.04, and after P, 19%±16.7 (SD), p=0.01. There
was no statistically significant difference on the LAR between M
and P. After FP the percentage eosinophils in sputum (sputum
eos%) was significantly reduced at 7 h, 11%±17.1 (SD) compared
to after P, 26%±27.4 (SD), p=0.02. Also after M sputum eos% was
significantly reduced, 14%±15.5 (SD), compared to P, p=0.03. In
opposite to eosinophils in sputum % there was no difference in
blood eosinophils for the different treatments. Metacholine respon-
siveness at 24 h was in relation to P reduced by 2.2 dose steps after
FP and by 0.2 dose steps after M (p=0.01).
Conclusion: In theses allergic asthmatics, fluticasone propionate
inhibited the LAR, reduced the associated sputum eosinophilia and
the metacholine responsiveness more effectively than montelukast.
The superior anti-inflammatory effects by fluticasone propionate
are confirmed.
P 3 - Close association between thyroid autoimmunity/
autoimmune disease and chronic idiopathic urticaria
Zauli D, Contestabile S, Grassi A, Zucchmi S, D'Ecclesia AR
Abstract: Almost 20 years ago now a fairly high prevalence of
thyroid autoantibodies was described in patients with chronic
urticaria of unknown origin (idiopathic).
We have subsequently confirmed a stronger association in a
series of 122 patients. In the present study, we have updated our
data in a larger series of such patients: 246 cases, comprising 148
women and 88 men.
Anti-thyroid peroxidase antibody (anti-TPO) alone was found
in 6%, anti-thyroglobulin (anti-TG) alone in 3.6% and both
antibodies in 13%. Any autoantibody was therefore detected in
23.7% cases, which is significantly higher than the expected preva-
lence in the general population: 1-10%.
As expected prevalence rates were higher in wornen than in
men: 29% vs 14.7%.
A condition of frank or subclinical dysthyroidism was present in
about 40% antibody positive cases. Whereas both hypo (32%) and
hyperthyroidism (9%) were detected in female patients, in men
only hypothyroidism (38%) was documented.
A low rate of response of urticaria symptoms to treatment of the
thyroid dysfunction was observed in our cases.
In conclusion, although many recently published guidelines for
the management of chronic idiopathic urticaria do not include
evaluation of thyroid autoimmunity and function and the benefit of
treatment seems low, we still highly recommend to test for anti-TPO,
anti-TG and serum thyrotropin all idiopathic cases. This also in view
of the morbidity associated with both hypo and hyperthyroidism.
P 4 - Quality of life and capsaicin sensitivity in patients
with airway symptoms induced by chemical agent
Ternesten-Hasséus E, Löwhagen O, Millqvist E
Asthma and Allergy Research Group, Department of Respiratory Medicine and
Allergy, Sahlgrenska University Hospital, Göteborg, Sweden
Email: ewa.ternesten@lungall.gu.se
Objectives: Earlier studies have shown increased cough sensitivity
to inhaled capsaicin in patients developing airway symptoms from
chemical agents, but without bronchoconstriction or an IgE-
mediated allergy.
Our aim was to study cough sensitivity to and reproducibility of
a capsaicin inhalation test in such patients, and to illuminate health
economical factors and estimate their quality of life.
Methods: Eighteen patients with airway symptoms triggered by
chemical agents, but with negative asthma/allergy tests, were
provoked with a capsaicin inhalation test in three increasing dose
steps, every third month. They were interviewed once a month about
their work capacity and medication. Quality of life was measured
with a general health profile (Nottingham Health Profile [NHP]).
Results: The mean number of coughs on the second dose of
capsaicin was 49 [32; 66] at the first visit, 54 [35; 72] at the second, 54
[37; 70] at the third, and 43 [27; 59] at the last visit. The corres-
ponding values among healthy control subjects were 9 [6; 12].
Eleven per cent of the patients had early disability retirement, 50%
were periodically on sick leave and 56% had changed work because of
their sensitivity to chemicals. Thirty-three per cent took nasal de-
congestants regularly and 50% used medication for the lower airways.
The NHP showed an influence on several dimensions of daily life.
Condusions: Sensitivity to inhaled capsaicin seems to be stable and
to have good reproducibility. Airway symptoms induced by
chemical agents have a great influence on patients’ quality of life
and on health economical factors.
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