Autoimmune phenomena in bronchial asthma with special reference to aspirin intolerance

Abstract

We assessed the autoimmune status of 185 adult patients with bronchial asthma and 46 healthy subjects of similar sex and age. The patients were divided into groups with: (1) aspirin-induced asthma (AIA) (n = 80); (2) intrinsic asthma with good aspirin tolerance (n = 46); and (3) atopic asthma (n = 59). Antinuclear antibodies (ANA) at a titer of > or = 1:40 were present in the serum of 55% of the patients with AIA, 41% of those with intrinsic asthma, 39% of those with atopic asthma, and 11% of the healthy subjects, with the difference between each patient group and the healthy subjects being statistically significant (p < 0.05). The fluorescence staining pattern of ANA on Hep-2 cells was mainly speckled, but the precise antigen specificity of the antibodies could not be identified with reference sera against extractable nuclear antigens. None of the subjects exhibited anti-double stranded deoxyribonucleic acid (anti-ds-DNA) or anti-neurtrophil cytoplasmic antibodies (ANCA). Positive ANA were associated with signs of complement activation, the presence of rheumatoid factor, and circulating immune complexes. Clinical signs of autoimmunity, evidenced by rheumatic symptoms, cold sensitivity, and Raynaud's phenomenon, were more common among the patients who tested positively for ANA. The assessment of autoimmunity may help in better characterizing patients with asthma and understanding various symptoms of the disease. Any causal relationship between asthma and autoimmunity remains to be established.