Despite large inroads into understanding the comparative pathology of atopic and non-atopic asthma in the past decade, and appreciation that the airways mucosa is a key site of IgE synthesis, and that such synthesis may not always be detectable peripherally and not always directed against conventional “aeroallergens”, non-atopic asthma remains an enigma. A working hypothesis of mechanisms of intrinsic asthma, built around the possible roles of IgE is presented in Fig. 1. In terms of the bronchial mucosal cellular infiltrate and local expression of cytokines and chemokines that are thought to be important in disease pathogenesis, atopic and non-atopic asthma are very similar diseases.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
Rackeman FM (1947) A working classification of asthma. Am J Med 33:601–606
Rackeman FM, Burrage WS, Irwin JW (1950) Intrinsic asthma. Postgrad Med 8:134–140
Johansson SGO, Hourihane JO'B, Bousquet J (2001) A revised nomenclature for allergy: an EAACI position statement from the EAACI nomenclature task force [position paper]. Allergy 56:813–824
Mungan D, Bavbek S, Peksari V (2001) Trichophyton sensitivity in allergic and nonallergic asthma. Allergy 108:21–28
Kauffmann F, Dizier M-H (1995) EGEA (Epidemiological study on the Genetics and Environment of Asthma, bronchial hyperresponsiveness and atopy) – design issues. Clin Exp Allergy 25:19–22
Romanet-Manent S, Charpin D, Magnan A, Lanteaume A, Vervloet D (2002) Allergic vs. nonallergic asthma: what makes the difference? Allergy 57:607–613
Kroegel C, Jager L, Walker C (1997) Is there a place for intrinsic asthma as a distinct immuno-pathological entity? Eur Respir J 10:513–515
Sporik R, Holgate ST, Platts-Mills T (1990) Exposure to house dust mite allergen (Der p1) and the development of asthma in childhood. N Engl J Med 323:502–507
Peat JK, Salome CM, Woolcock AJ (1990) Longitudinal changes in atopy during a 4-year period: relation to bronchial hyperresponsiveness and respiratory symptoms in a population sample of Australian schoolchildren. J Allergy Clin Immunol 85:65–74
Gotzsche PC, Johansen HK, Hammarquist C (2001) House dust mite control measures for asthma [Cochrane review]. The Cochrane Library, issue 3. Oxford Update Software.
Barbee RA, Hallon M, Kaltenborn W (1987) A longitudinal study of serum IgE in a community cohort: correlations with age, sex, smoking and atopic status. J Allergy Clin Immunol 79:919–927
Burrows B, Martinez FD, Halonen M, Barbee RA, Cline MG (1989) Association of asthma with serum IgE levels and skin-test reactivity to allergens. N Engl J Med 320:271–277
Beeh KM, Ksoll M, Buhl R (2000) Elevation of total serum immunoglobulin E is associated with asthma in nonallergic individuals. Eur Respir J 16:609–614
Van Eerdewegh P, Little RD, Dupuis J (2002) Association of the ADAM33 gene with asthma and bronchial hyperresponsiveness. Nature 418:426–430
Humbert M, Grant JA, Taborda-Barata L (1996) High-affinity IgE receptor (FcepsilonRI)-bearing cells in bronchial biopsies from atopic and nonatopic asthma. Am J Respir Crit Care Med 153:1931–1937
Ying S, Humbert M, Meng Q (2001) Local expression of epsilon germline gene transcripts and RNA for the epsilon heavy chain of IgE in the bronchial mucosa in atopic and nonatopic asthma. J Allergy Clin Immunol 107:686–692
Takhar P, Corrigan CJ, Smurthwaite L, O'Connor BJ, Durham SR, Lee TH, Gould HJ (2007) Class switch recombination to IgE in the bronchial mucosa of atopic and nonatopic patients with asthma. J Allergy Clin Immunol 119:213–218
Gould HJ, Takhar P, Harries HE, Durham SR, Corrigan CJ (2006) Germinal-centre reactions in allergic inflammation. Trends Immunol 27:446–445
Takhar P, Smurthwaite L, Coker CA, Fear DJ, Banfield GK, Carr VA, Durham SR, Gould HJ (2005) Allergen drives class switching to IgE in the nasal mucosa in allergic rhinitis. J Immunol 174:5024–5032
Smurthwaite L, Walker SN, Wilson DR, Birch DS, Merrett TG, Durham SR, Gould HJ (2001) Persistent IgE synthesis in the nasal mucosa of hay fever patients. Eur J Immunol 31:3422–3431
Gould HJ, Takhar P, Harries HE, Chevretton E, Sutton BJ (2007) The allergic march from Staphylococcus aureus superantigens to immunoglobulin E. Chem Immunol Allergy 93:106–136
Riechelmann H, Essig A, Duetschle T, Rau A, Rothermel B, Weschta M (2005) Nasal carriage of Staphylococcus aureus in house dust mite allergic patients and healthy controls. Allergy 60:1418–1423
Bachert C, Gevaert P, Howarth P, Holtappels G, van Cauwenberge P, Johansson SGO (2003) IgE to Staphylococcus aureus enterotoxins in serum is related to severity of asthma. J Allergy Clin Immunol 111:1131–1132
Berger WE (2002) Monoclonal anti-IgE antibody: a novel therapy for allergic airways disease. Ann Allergy Asthma Immunol 88:152–160
Novembre E, Cianferoni A, Lombardi E (2001) Natural history of “intrinsic” atopic dermatitis. Allergy 56:452–453
Kerschenlohr K, Decard S, Darsow U (2003) Clinical and immunologic reactivity to aero-allergens in “intrinsic” atopic dermatitis patients. J Allergy Clin Immunol 111:195–197
Bentley AM, Menz G, Storz C (1992) Identification of T lymphocytes, macrophages and activated eosinophils in the bronchial mucosa in intrinsic asthma: relationship to symptoms and bronchial responsiveness. Am Rev Respir Dis 146:500–506
Bentley AM, Durham SR, Kay AB (1994) Comparison of the immunopathology of extrinsic, intrinsic and occupational asthma. J Invest Allergol Clin Immunol 4:222–232
Humbert M, Durham SR, Ying S (1996) IL-4 and IL-5 mRNA and protein in bronchial biopsies from patients with atopic and nonatopic asthma: evidence against “intrinsic” asthma being a distinct immunopathologic entity. Am J Respir Crit Care Med 154:1497–1504
Ying S, Humbert M, Barkans J (1997) Expression of IL-4 and IL-5 mRNA and protein product by CD4 + and CD8 + T cells, eosinophils, and mast cells in bronchial biopsies obtained from atopic and nonatopic (intrinsic) asthmatics. J Immunol 158:3539–3544
Humbert M, Durham SR, Kimmitt P (1997) Elevated expression of messenger ribonucleic acid encoding interleukin-13 in the bronchial mucosa of atopic and non-atopic asthma. J Allergy Clin Immunol 99:657–665
Kotsimbos TC, Ghaffar O, Minshall EM (1998) Expression of the IL-4 receptor alpha- subunit is increased in bronchial biopsy specimens from atopic and nonatopic asthma subjects. J Allergy Clin Immunol 102:859–866
Yasruel Z, Humbert M, Kotsimbos TC (1996) Membrane-bound and soluble alpha IL-5 receptor mRNA in the bronchial mucosa of atopic and nonatopic asthmatics. Am J Respir Crit Care Med 154:1497–1504
Humbert M, Ying S, Corrigan C (1997) Bronchial mucosal expression of the genes encoding chemokines RANTES and MCP-3 in symptomatic atopic and nonatopic asthmatics: relationship to the eosinophil-active cytokines interleukin (IL)-5, granulocyte macrophage-colony-stimulating factor, and IL-3. Am J Respir Cell Mol Biol 16:1–8
Ying S, Meng Q, Zeibecoglou K (1999) Eosinophil chemotactic chemokines (eotaxin, eotaxin-2, RANTES, monocyte chemoattractant protein-3 (MCP-3), and MCP-4), and C-C chemokine receptor 3 expression in bronchial biopsies from atopic and nonatopic (intrinsic) asthmatics. J Immunol 163:6321–6329
Novak N, Bieber T (2003) Allergic and nonallergic forms of atopic diseases. J Allergy Clin Immunol 112:252–262
Kotsimbos AT, Humbert M, Minshall E (1997) Upregulation of alpha GM-CSF-receptor in nonatopic asthma but not in atopic asthma. J Allergy Clin Immunol 99:666–672
Zeibecoglou K, Ying S, Meng Q (2000) Expression of eotaxin in induced sputum of atopic and non-atopic asthmatics. Allergy 55:1042–1048
Folkard SG, Westwick J, Millar AB (1997) Production of interleukin-8, RANTES and MCP-1 in intrinsic and extrinsic asthmatics. Eur Respir J 10:2097–2104
Walker C, Bode E, Boer E, Hansel TT, Blaser K, Virchow JC (1992) Allergic and non-allergic asthmatics have distinct patterns of T-cell activation and cytokine production in peripheral blood and BAL. Am Rev Respir Dis 146:109–115
Virchow JC, Walker C, Hafner D (1995) T cells and cytokines in bronchoalveolar lavage fluid after segmental allergen challenge in atopic asthma. Am J Respir Crit Care Med 151: 960–968
Christodoulopoulos P, Cameron L, Nakamura Y (2001) Th2 cytokine-associated transcription factors in atopic and nonatopic asthma: evidence for differential signal transducer and activator of transcription 6 expression. J Allergy Clin Immunol 107:586–591
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2009 Springer
About this chapter
Cite this chapter
Corrigan, C. (2009). Non-atopic Asthma: A Continuing Enigma. In: Pawankar, R., Holgate, S.T., Rosenwasser, L.J. (eds) Allergy Frontiers: Clinical Manifestations. Allergy Frontiers, vol 3. Springer, Tokyo. https://doi.org/10.1007/978-4-431-88317-3_20
Download citation
DOI: https://doi.org/10.1007/978-4-431-88317-3_20
Publisher Name: Springer, Tokyo
Print ISBN: 978-4-431-88316-6
Online ISBN: 978-4-431-88317-3
eBook Packages: MedicineMedicine (R0)