アレルギーと治療のジャーナル

概要

Protective Effects of Oral Disodium Cromoglycate on the Asthmatic Responses Induced by Food Allergy

Zdenek Pelikan

Background: The food allergy can also participate in the pathological mechanism underlying the bronchial asthma. This should ultimately be confirmed by food ingestion challenge combined with monitoring of lung function (FVC and FEV1), demonstrating the particular types of asthmatic response to ingested foods. The oral disodium cromoglygate (DSCG, Nalcrom®) has been shown to be effective drug in prevention of food allergy.

Methods: In 62 randomly selected patients with bronchial asthma developing 62 asthmatic responses to food ingestion challenge (17 immediate, IAR, p<0.01; 21 late, LAR, p<0.001; 8 dual late, DLAR, p<0.05; 11 delayed, DYAR, p<0.05; and 5 dual delayed DDYAR, p<0.05), the food ingestion challenges have been repeated twice, after the pretreatment with oral DSCG and after pretreatment with oral placebo. The study was performed according the double-blind, placebo-matched, cross-over design.

Results: The DSCG, administered orally in a daily dose of 4×200 mg starting 2 weeks before and continuing through the challenge day up to 3 days after the challenge, as compared with placebo, protected highly significantly the IAR (p<0.001), and the LAR (p<0.001), protected distinctly significantly the DLAR (p<0.01) and significantly the DYAR (p<0.05) and DDYAR (p<0.05). However, the distribution of the protective effects of oral DSCG on the particular types of asthmatic response to ingested foods has varied. The oral placebo was fully ineffective (p>0.2). No differences in the DSCG protective effects were observed with respect to the individual foods (p>0.2).

Conclusions: It can be concluded that the food allergy can causally be involved in some patients with bronchial asthma, resulting in development of various types of asthmatic response. The asthmatic responses to food ingested can effectively be prevented by pretreatment with disodium cromoglycate administered orally in a daily dose of 4x 200 mg. If necessary the treatment with oral DSCG can be combined with other treatments, such as elimination diet and/or other additional drugs, e.g. β2–sympathomimetics or other drugs.