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Proceedings of the British Thoracic Society Thorax: First Published As 10.1136/Thx.49.4.387P on 1 April 1994

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Proceedings of the British Thoracic Society Thorax: First Published As 10.1136/Thx.49.4.387P on 1 April 1994 Thorax 1994:49:387P-434P 387P Proceedings of the British Thoracic Society Thorax: first published as 10.1136/thx.49.4.387P on 1 April 1994. Downloaded from The British Thoracic Society's winter 1993 meeting was held on 8-10 December 1993 at Kensington Town Hall, London Effect of the PAF antagonist UK-74 505 on experimental lung castle General Hospital, University ofNewcastle Upon Tyne We have injury in mice used the postal questionnaire of the EC Study of Asthma Prevalence and Risk Factors as the initial phase of a comparable investigation JM MIOTLA, TJ WILLIAMS, PK JEFFERY, PG HELLEWELL Departments of within the Northern Health Region. We hope to evaluate the back- Lung Pathology and Applied Pharmacology, National Heart and Lung ground prevalence of asthma (and airway responsiveness) in young Institute, London We have shown that intravenous lipopolysacchar- adults of working age (20-44 years) and to assess its dependence on ide (LPS) and zymosan treatment induces plasma protein accumula- area of residence (west v east coast) and gender in order to provide tion in the lung, which is dependent upon neutrophil accumulation control data for industrial populations in our region at risk of but not their emigration into alveolar interstitium (Miotla et al. Am developing occupational asthma. The questionnaire was mailed to Rev Respir Dis 147: A69). We have now investigated the role of PAF random samples of West Cumbrian (WC) men, Newcastle men, and in the induction of neutrophil sequestration and vascular permeabi- Newcastle women identified from FHSA registers. Investigation of a lity changes. BALB/c mice (20 g) received i.v. LPS two (3 mg/kg) sample of non-responders indicated that most had moved from the hours prior to i.v. zymosan (10mg/kg). The PAF antagonist, UK- addresses provided, leaving participation rates for those presumed to 74 505 (0 5 mg/kg) was injected i.v. 15 minutes prior to LPS. Ac- have received the questionnaire (and up to two reminders) of 85 10% cumulation of '52I-human serum albumin ('251I-HSA), co-injected from WC men, 8399% from Newcastle men, and 8544% from with zymosan, was assessed in lung tissue after 30 minutes. ''I-HSA Newcastle women. There were no significant differences in the age injected i.v. five minutes before sacrifice was used as a marker of distribution between the three groups. The results are shown in the intravascular volume. The activities of "'2I-HSA and ''I-HSA in lung table. We conclude that (1) the only evidence of a geographic effect tissue were assessed simultaneously in a gamma counter and com- was to the question "have you ever wheezed" (more frequent in pared with that in plasma. Albumin accumulation in the lung was Newcastle), and (2) the only evidence of a gender effect was to the expressed as Il of plasma retained extravascularly. Accumulation of question "have you woken coughing in the last year" (more frequent plasma increased from 1-3 (0 4) p1 (n = 4) in the saline-treated group in women). to 10 7 (1-9) (n= 7, p <O OOl) after combined LPS and zymosan. Pretreatment with UK-74 505 reduced plasma accumulation to 2 9 WC Newcastle tl p < Combined LPS and treatment Symptom Newcastle (08) (n= 5, 0001). zymosan men men women resulted in a marked diffuse accumulation of neutrophils and focal (n= 1802) (n= 1368) (n= 1679) aggregates as seen by light microscopy. UK-74 505 had no noticeable effect on the diffuse accumulation of neutrophils nor on the intensity Ever wheezed *39.9% *440% 41 7% Waking with tight chest in last and frequency of the aggregates. In conclusion, blockade of PAF year 17l1% 18-8% 20-6% http://thorax.bmj.com/ receptors reduces lung plasma protein extravasation induced by LPS Waking breathless in last year 866% 9o8% 10-2% and zymosan but does not modify neutrophil accumulation. The Waking coughing in last year 23-0% **24.7% **36l1% attenuation of accumulation UK-74 505 may be Asthma attack in last year 5-2% 477% 6-1% plasma protein by by Currently taking asthma blockade of PAF receptors located on vascular endothelial cells or on medication 7-3% 6-9% 7-9% the intravascular neutrophils. *p = 0-019; **p = 0-017 (X2 test) Prevalence of asthma and probable "asthma" in Blackburn P MYERS, LP ORMEROD Chest Clinic, Blackburn Royal Infirmary, Association of age, sex and smoking with total IgE and speci- Blackburn, Lancashire A respiratory questionnaire administered by fic IgE in young adults living in East Anglia on October 4, 2021 by guest. Protected copyright. health visitor and translator was completed by 1783 persons, 96 6% of all the Asian patients in three local practices. The age breakdown of D JARVIS, P BURNEY, S CHINN, C LUCZYNSKA, E LAI, R HALL, B HARRISON, the survey was similar to that for the Asian district population in the J STARK Department of Public Health Medicine, UMDS; Department 1991 census. 181 (10-2%) were known asthmatics. Only 121 (6 8%) ofRespiratory Medicine, The Ipswich Hospital; Department ofRespira- were current, and 28 (1-6%) ex-smokers. There was no correlation tory Medicine, West Norwich Hospital; Department of Respiratory between any symptoms/treatment and social class or the Jarman Medicine, Addenbrookes Hospital, Cambridge As part of the British index of the patients' addresses. Those born in the UK were more arm of The European Community Respiratory Health Survey blood likely to describe respiratory symptoms, but there were increasing samples for determination of total IgE and specific IgE to D pteronys- rates of symptoms and medication use with increasing time in the sinus, cat and timothy grass were taken from a random sample of 854 UK. The prevalence of diagnosed asthma was 9-16% in the under young adults living in three areas in East Anglia. Smoking was 15s, fell to 4 5-9% between the ages of 20-49, but rose to 12-17% in recorded as non-smoker (NS), ex-smoker (EXS), and current smoker those aged over 50. Positive responses to the questions: night time (CS) (table 1). In a multiple regression model with adjustment for cough (n = 157), morning tightness (n = 127), wheeze after exercise age, sex and area the overall effect of smoking on total IgE was (n = 152), couigh with change of air temperature (n = 170), and a significant (p < 0 05), the lowest total IgE values being in EXS. In a history ofwheezy breathing (n = 231) all suggested under diagnosis of logistic regression model, excluding subjects who had experienced asthma. If those non-smokers with positive responses to one or more childhood asthma attacks, and with adjustment for age, sex, area and of the above were not known to be asthmatic they were regarded as total IgE, the odds ratios for a positive RAST (> 0.35 kU/l) to the having "probable" asthma. The total prevalence of asthma (dia- three allergens were as shown in table 2. The relation between gnosed and probable) rises to 17-22% in children, 9-19% between smoking and specific IgE after adjustment for total IgE is not the ages 20-49, and to 22-34% in the over 50s. Patients born in the UK were more likely to be diagnosed as asthmatic than those born abroad; those born abroad had a similar percentage with symptoms and were Table I Geometric mean total IgE (kU/lj more likely to have undiagnosed "probable" asthma. The survey shows a high prevalence of asthma in Asian patients of all ages in the Men Women UK. Age Mean (95% CI) Mean (95% CI) Effects of geography and gender on the prevalence of asthma 20-24 40 3 (26 7-606) 24-3 (147-40-1) symptoms: results of a postal survey 25-29 47 1 (30 7-72 4) 21.0 (15 6-28 5) 30-34 29-4 (177-48 8) 32-2 (231-44 8) G DEVEREUX, SMT AYATOLLAHI, K FISHWICK, SJ BOURKE, DJ HENDRICK 35-39 33.7 (244-46-6) 22 8 (16 9-30 7) Chest Unit and Regional Unit for Occupational Lung Disease, New- 40-44 34-3 (24-0-490) 196 (173-325) 388P Proceedings of the British Thoracic Society Table 2 Odds ratios for positive RAST to allergens audit at this hospital (Thorax 1992;47:884P) a questionnaire survey was prospectively performed on 41 consecutive admissions with acute D pteronyssinus Cat Grass severe asthma. The objective was to compare actual community NS 100 100 100 management with recommended guidelines for the management of EXS 1 26 (0 75-2 08) 0 78 (0 37-1 60) 0 64 (0 39-1 05) asthma. Patient characteristics were: 30 females ofmean age 38 (range Thorax: first published as 10.1136/thx.49.4.387P on 1 April 1994. Downloaded from Cs 1 60 (1 02-2 48) 0 47 (0 22-1 00) 0 45 (0 28-0 71) 18-67); seven current smokers. Seventeen (44%) had had asthma for less than 10 years. Thirty nine of 41 (95%) had consulted their GP with asthma symptoms in the past year (mean 10 visits; range 1-52). same for all allergens. [This work was supported by the National Twenty one of 41 (51 %) were using a home peak flow meter (mean Asthma Campaign.] 2-0, range 0-4 times per day), in 14 for over six months. Night waking had occurred on each of the seven nights prior to admission in 23/41 (56%). Medication prior to the index attack had included: beta-2 What is an asthma death? Results of a cohort study of patients agonists - inhaled (37), oral (6), nebulised (9); anticholinergics (14); discharged following inpatient treatment for asthma theophyllines (14); and steroids - inhaled (32, with spacer 16), oral (4).
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