This important publication presents new information regarding "Late Phase Allergic (or Inflammatory) Reactions" (LPR). It includes present knowledge on the pathogenesis of LPR in human skin, nose, bronchi, and other organ systems. The book discusses the roles of antibodies, mediators, and cells as well as animal models of LPR. It describes the importance of LPR in the pathogenesis of chronic disease and the possibilities of their pharmacological modulation. The authors discuss clinical conclusions to be drawn from the observation of LPR, such as continuous treatment and immunotherapy. This volume is a useful reference for scientists and clinicians wishing to understand more about the problems of their allergic patients.
INTRODUCTION. History and Introduction: Late Phase Allergic Reactions. Definitions and Clinical Symptoms. PATHOGENESIS of LCR. Trigger Mechanisms. IgE-Antibodies. IgE-Independent Mechanisms. Exudate from Human Wheal and Flare Reactions. Mast-Cell-Derived Mediators. Role of Mediators. Histamine. Prostaglandins. Leukotrienes. Thromboxanes. Platelet Activating Factor. Activation of the Clotting System and Fibrin Deposition in Human LCR. Kallikrein-Kinin System. The Role of Inflammatory Cells in LPR. PATHOGENESIS of LNR. Late Nasal Response-Its Clinical Characterisitics, Features, and Possible Mechanism. PATHOGENESIS of LBR. IgE-Dependent Mechanisms in the Induction of LBR. Exercise-Induced Asthma and LBR. Chemotactic Factors and Allergen-Induced LBR. The Use of Bronchoalveolar Lavage (BAL) to Study Late-Phase Allergic Asthma. Platelets and Asthma. On the Central Role of Vascular Endothelium in Allergic Reactions. PHARMACOLOGIC MODULATION of LPR of the SKIN, NOSE, and BRONCHIAL SYSTEM. Corticosteroids. The Influence of Sodium Cromoglycate and Nedocromil Sodium on LPR. Beta-Adrenergic Agonists. Muscarinic Cholinergic Antagonists. Histamine Receptor Antagonists. Ketotifen. Xanthines. Nonsteroidal Anti-Inflammatory Drugs. Thromboxane Synthetase Inhibitors. Tranexamic Acid. Onion Extracts. 5,8,11,14-Eicosatetraynoic Acid. ANIMAL MODELS of LPR. Rat Skin Tests. Late Phase Asthma in an Allergic Rabbit Model. Late Phase Bronchial Reaction in Sheep. Late Bronchial Responses in the Guinea Pig. Skin Test on Monkeys. LPR and CHRONIC ALLERGIC DISEASES. Lung Function Parameters in Late Bronchial Reactions and Chronic Bronchial Asthma. Bronchial Hyperreactivity and the Late Phase Reaction in Bronchial Asthma. The Role of Leukotrienes in Chronic Lung Diseases. PAF, Platelets, and Bronchial Hyperreactivity. Eosinophils and Chronic Bronchopulmonary Disorders. Alveolar Macrophages and Bronchial Asthma. Chronic Urticaria and Late Phase Reactions. The Tangled Web: Cooperation and Interdependency of Mediator Systems in Inflammation. Regulatory Mechanisms. Pathogenesis and Possible Mechanisms Underlying the Late Phase Reactions. CLINICAL CONSEQUENCES. Differential Diagnosis of the Late Phase Reactions. Drug Therapy: The Effect of Continuous Treatment on Late Phase Reactions. The Effects of Immunotherapy on Late Phase Reactions. Summary and Conclusions. Index.