Am. J. Respir. Crit. Care Med., Volume 160, Number 1, July 1999, 33-39

The Effect of Exposure to Ozone and Nitrogen Dioxide on the Airway Response of Atopic Asthmatics to Inhaled Allergen
Dose- and Time-dependent Effects

HUW S. JENKINS, JAGDISH L. DEVALIA, REBECCA L. MISTER, ANDREW M. BEVAN, CSABA RUSZNAK, and ROBERT J. DAVIES

Academic Department of Respiratory Medicine, St. Bartholomew's and the Royal London School of Medicine and Dentistry, London Chest Hospital, London, United Kingdom

Eleven mild atopic asthmatic patients were exposed for 6 h, in randomized order, to air, 100 ppb O₃, 200 ppb NO₂, and 100 ppb O₃ + 200 ppb NO₂, followed immediately by bronchial allergen challenge. Subsequently 10 of these patients were exposed for 3 h to air, 200 ppb O₃, 400 ppb NO₂, and 200 ppb O₃ + 400 ppb NO₂, followed immediately by bronchial allergen challenge. All exposures were carried out in an environmental chamber, with intermittent moderate exercise, and a minimal interval of 2 wk. Exposure for 6 h to 100 ppb O₃, 200 ppb NO₂, and 100 ppb O₃ + 200 ppb NO₂ did not lead to any significant increase in the airway response of these individuals to inhaled allergen, when compared with exposure for 6 h to air. In contrast, exposure for 3 h to 200 ppb O₃, 400 ppb NO₂, and 200 ppb O₃ + 400 ppb NO₂ significantly decreased the dose of allergen (in log cumulative breath units [CBU]) required to decrease FEV₁ by 20% (allergen PD₂₀FEV₁), compared with exposure to air (geometric mean CBU: 3.0 for air versus 2.66 for O₃ [p = 0.002]; 2.78 for NO₂ [p = 0.018]; 2.65 for O₃ + NO₂ [p = 0.002]). These results suggest that the pollutant-induced changes in airway response of mild atopic asthmatics to allergen may be dependent on a threshold concentration rather than the total amount of pollutant inhaled over a period of time.

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