Am. J. Respir. Crit. Care Med.,
Volume 160, Number 5, November 1999, 1516-1524
Relationship of Cellular Transmigration and Airway
Response after Allergen Challenge
IKEADI MAURICE
NDUKWU,
EDWARD T.
NAURECKAS,
CHRISTOPHER
MAXWELL,
MICHAEL
WALDMAN,
and
ALAN R.
LEFF
Section of Pulmonary and Critical Care Medicine, and the Committees on Cellular Physiology and Clinical Pharmacology,
Division of the Biological Sciences, The University of Chicago, Chicago, Illinois
We examined the relationship between eosinophil migration into the bronchoalveolar space and
change in FEV1 after endobronchial allergen challenge (EBAC) in atopic asthmatic (AA) and atopic nonasthmatic (ANA) subjects. The purpose of this study was to obtain continuous, intrasubject controlled assessment of the relationship between cell migration in control and allergen-challenged segments in the same individuals over 96 h. In AA subjects, the eosinophil (Eos) count in the bronchoalveolar lavage fluid (BALF) increased from a baseline of 7,896 ± 3,865 to 416,476 ± 231,012 Eos/ml
by 72 h (p = 0.001) in the challenged segment post-EBAC. For ANA subjects, the postsegmental challenge count was 29,874 ± 474 Eos/ml (p = 0.03 versus baseline and p < 0.05 AA peak versus ANA
peak). In both groups, there was a comparable decrease in peripheral blood eosinophil count beginning 5 h after challenge, which resolved at 24 h. In AA subjects, 416,476 ± 231,012 Eos/ml was obtained from the allergen-challenged segment and 23,522 ± 8,298 Eos/ml was obtained from the
sham-challenged segment (p < 0.001) at 72 h. In contrast, there was no difference in the Eos count
obtained from the BALF between the antigen- and sham-challenged segments of ANA subjects. We
also found that increased airway neutrophils were present in equal numbers in allergen-challenged
and sham-challenged segments in both AA and ANA subjects. We conclude that augmented eosinophil migration after EBAC is a characteristic of atopic asthma and is not present in atopic subjects
who do not have asthma. We find that BAL eosinophilia in ANA patients as well as neutrophilia in
both ANA and AA subjects are nonspecific consequences of bronchoscopy. Finally, we find no relationship between specific airway eosinophil migration into the BALF and FEV1 < 72 h after challenge;
however, at 96 h, there is a substantial decrease in FEV1 that accompanies BALF eosinophilia. Ndukwu
IM, Naureckas ET, Maxwell C, Waldman M, Leff AR. Relationship of cellular transmigration and
airway response after allergen challenge.
