MODIFICATIONS OF PC20 AND MAXIMAL DEGREE OF AIRWAY NARROWING TO METHACHOLINE AFTER POLLEN SEASON IN POLLEN SENSITIVE ASTHMATIC-PATIENTS

We examined the effect of cessation of exposure to pollen on non-specific airway responsiveness in 10 grass and/or parietaria pollen sensitive asthmatics. Three methacholine inhalation challenges were performed, the first during pollen season (seasonal period), the second 2 months after the end of season (short time after seasonal period), and the third 5 months after the end of season (long time after seasonal period). The dose response curves to methacholine were characterized by the PC20 (provocative concentration of methacholine required to produce a 20% fall in FEV1) and maximal response plateau, if possible. A maximal response plateau on the dose-response curve was considered to be present if three or more data points for FEV1 fell within a 5% response range. The challenge was stopped when FEV, dropped more than 50% or the highest concentration of methacholine (200 mg/ml) was reached. The geometric mean (range) methacholine PC20 increased from 1.08 (0.18-37.22) in the seasonal period to 4.67 (0.71 200) mg/ml during the long time after seasonal period (P < 0.01). On the other hand, in six subjects in whom it was possible to obtain a plateau on at least one challenge, the level of the maximal response decreased from (mean +/- s.e.m.) 44.1 +/- 4.9 in the seasonal period to 30 +/- 4-4 during the long time after seasonal period (P < 0.05). These results suggest that in pollen sensitive asthmatic patients, the cessation of exposure to pollen is associated with a reduction of non-specific bronchial responsiveness (PC20 and maximal degree of airway narrowing to methacholine).