Am. J. Respir. Crit. Care Med., Vol 152, No. 6, Dec 1995, 1753-1756.
Autoimmune phenomena in bronchial asthma with special reference to aspirin intolerance
A Szczeklik, E Nizankowska, A Serafin, A Dyczek, M Duplaga and J Musial
Department of Medicine, Jagiellonian University School of Medicine, Cracow, Poland.
We assessed the autoimmune status of 185 adult patients with bronchial
asthma and 46 healthy subjects of similar sex and age. The patients were
divided into groups with: (1) aspirin-induced asthma (AIA) (n = 80); (2)
intrinsic asthma with good aspirin tolerance (n = 46); and (3) atopic
asthma (n = 59). Antinuclear antibodies (ANA) at a titer of > or = 1:40
were present in the serum of 55% of the patients with AIA, 41% of those
with intrinsic asthma, 39% of those with atopic asthma, and 11% of the
healthy subjects, with the difference between each patient group and the
healthy subjects being statistically significant (p < 0.05). The
fluorescence staining pattern of ANA on Hep-2 cells was mainly speckled,
but the precise antigen specificity of the antibodies could not be
identified with reference sera against extractable nuclear antigens. None
of the subjects exhibited anti-double stranded deoxyribonucleic acid
(anti-ds-DNA) or anti-neurtrophil cytoplasmic antibodies (ANCA). Positive
ANA were associated with signs of complement activation, the presence of
rheumatoid factor, and circulating immune complexes. Clinical signs of
autoimmunity, evidenced by rheumatic symptoms, cold sensitivity, and
Raynaud's phenomenon, were more common among the patients who tested
positively for ANA. The assessment of autoimmunity may help in better
characterizing patients with asthma and understanding various symptoms of
the disease. Any causal relationship between asthma and autoimmunity
remains to be established.
