Background: Patients with allergic bronchial asthma develop various asthmatic response types to bronchial challenge with allergen, such as immediate (IAR), late (LAR), dual late (DLAR) or delayed (DYAR), displaying different clinical, immunologic and pharmacologic features. This study deals with count changes of particular blood cells accompanying the IAR, LAR and DYAR. Methods: In 63 patients developing 22 IAR, 26 LAR and 15 DYAR, the repeated allergen challenges were supplemented with recording of blood cell counts, Th1/Th2 ratio, leukotrines B4 (LTB4) and C4 (LTC4), eosinophil cationic protein (ECP), myeloperoxidase (MPO), and histamine in blood, and intracellular IFN-γ and IL-4 in peripheral blood mononuclear cells. Results: The IAR was accompanied by increased eosinophil and basophil counts, increased serum concentrations of histamine, LTC4 and ECP, decreased Th1/Th2 ratio in favour of Th2 cells, and increased intracellular IL-4. The LAR was associated with increased eosinophil and neutrophil counts, increased serum concentrations of LTC4 and LTB4, unchanged Th1/Th2 ratio, and increased intra-cellular IL-4. The DYAR was accompanied by increased total leukocyte, neutrophil, monocyte, lymphocyte and thrombocyte counts, increased serum concentrations of LTB4 and MPO, increased Th1/Th2 ratio in favour of Th1 cells, and increased intracellular IFN-γ. Conclusions: These results provide evidence for different involvement of particular blood cell types and different hypersensitivity mechanisms in IAR, LAR and DYAR. The monitoring of peripheral blood cell counts seems to be an useful supplementary parameter to the bronchial challenge with allergen.
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