Kinetics of the development and recovery of the lung from IgE-mediated inflammation: dissociation of pulmonary eosinophilia, lung injury, and eosinophil-active cytokines

Am J Respir Crit Care Med. 1997 Feb;155(2):442-8. doi: 10.1164/ajrccm.155.2.9032176.


Events occurring up to 16 d after antigen challenge were characterized using a novel protocol employing four bronchoscopies, two segmental antigen challenge (SAC) procedures (on Days 1 and 2), and six bronchoalveolar lavages (BALs) (on Days 1, 2, 9, and 16) in three groups: ragweed allergic asthmatics with dual phase airway reactions (AA-D), allergic asthmatics with a single early airway reaction (AA-S), and nonallergic nonasthmatic control subjects. In AA-D subjects, SAC produced a marked eosinophilic inflammatory response at 24 h associated with eosinophil degranulation (eosinophil cationic protein [ECP] in BAL fluid) and lung injury, which largely resolved by Day 16. When the second antigen-challenged segment (SAC performed on Day 2) was lavaged 7 d after challenge (Day 9), a persistent pulmonary eosinophilia was noted accompanied by minimal elevations in ECP and albumin. Eosinophil-active cytokines showed unique patterns: interleukin-5 (IL-5) increased in the antigen segment on Day 2 then returned to baseline after 7 d; granulocyte-macrophage colony-stimulating factor (GM-CSF) peaked at Day 2 but was persistently elevated throughout Day 16 in antigen segments, and increased in control segments at late time points; IL-3 levels were constant and similar in antigen and control segments. Changes were specific to AA-D subjects in comparison with control subjects. Elements of the IgE-mediated pulmonary inflammatory response differ markedly in their development and resolution.

Publication types

  • Clinical Trial
  • Controlled Clinical Trial
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Allergens / adverse effects*
  • Antigens
  • Asthma / diagnosis*
  • Blood Proteins / analysis
  • Bronchial Provocation Tests
  • Bronchoalveolar Lavage
  • Bronchoscopy
  • Eosinophil Granule Proteins
  • Female
  • Humans
  • Immunoglobulin E / adverse effects*
  • Inflammation Mediators / analysis
  • Kinetics
  • Male
  • Pulmonary Eosinophilia / etiology
  • Pulmonary Eosinophilia / physiopathology*
  • Respiratory Function Tests
  • Ribonucleases*


  • Allergens
  • Antigens
  • Blood Proteins
  • Eosinophil Granule Proteins
  • Inflammation Mediators
  • Immunoglobulin E
  • Ribonucleases