ACCUMULATION OF BASOPHILS AND THEIR CHEMOTACTIC ACTIVITY IN THE AIRWAYS DURING NATURAL AIRWAY NARROWING IN ASTHMATIC INDIVIDUALS

To investigate cellular differentials in natural airway narrowing of steroid-dependent asthmatic individuals, we performed bronchoalveolar lavage (BAL) on 10 inpatients with asthma treated only with bronchodilators during episodes of natural airway narrowing evaluated by serial monitoring of peak expiratory flow (PEF), and on nine normal volunteers. We confirmed that the airway narrowing was not completely reversed by salbutamol aerosol just before the BAL study, but was completely reversed by administration of systemic steroid af ter the BAL study. Thus, the natural airway narrowing investigated in this study consisted not only of the constriction of airway smooth muscle, but also of edema of the airway mucosa and/or secretion in airways. Both the numbers and percentages of eosinophils and alcian blue-positive cells in BAL fluids from the asthmatic subjects were significantly higher than those of normals, but the numbers and percentages of neutrophils, lymphocytes, and macrophages were not. Thus, eosinophils and alcian blue-positive cells selectively increased in the airways during the natural airway narrowing. Because we found that the metachromatic cells consisted of two types, with a single nucleus and with segmented nuclei, we further examined basophil chemotactic activity (BCA) in BAL fluids. We showed that BCA was significantly higher in the asthmatic (79.3 +/- 17.2 cells/5 hpf) than in the normal subjects (6.2 +/- 1.6 cells/5 hpf), and also that the activity was more strongly correlated with the cells having segmented nuclei (p = 0.95) than with all of the cells (p = 0.73). In addition, we demonstrated that four low-molecular-weight substances (500-3,500-D) participated in the activity. Therefore, we concluded that basophils migrated into the airways from peripheral blood during the natural airway narrowing that occurs in steroid-dependent asthmatic individuals, despite bronchodilator therapy.