<原著>第 2 篇各種呼吸器疾患における血清 IgE 値の検討(呼吸器疾患における血清 IgE に関する研究)

Abstract

1. 気管支喘息, 気管支・肺感染症, 肺結核症, サルコイドージス, 塵肺, 肺気腫, 自然気胸, ベリリウム肺, 肺癌の患者についてradio immuno sorbent test (RIST)による血清IgE値の測定を行ない, 健康者群のIgE値と比較した。その結果, アトピー性気管支喘息および肺癌の両群ではIgE平均値がそれぞれ791 IU/ml, 349 IU/mlと健康者群のIgE値187 IU/mlと比較して明らかに高値であった。また塵肺群ではIgE平均値は162 IU/mlと対照に比して有意差を認めなかったが, その分布域は24 IU/ml&acd;1.078 IU/mlと対照群の約2倍の広範囲にわたって分布していた。その他の疾患群についてはIgE平均値についても, その分布域についても対照である健康者群との間に著明な差異を認めなかった。2. 肺癌患者の血清IgE値はその進展度による差異を認めなかった。組織型に関しては類表皮癌ではIgE値445 IU/mlで未分化癌のIgE値265 IU/mlと比較して0.05<p<0.1で有異差を認めた。3. 気管支・肺感染症群。肺感染症群塵肺群のうち28例についてpaper disc radio immunosorbent test (PRIST)による血清IgE値の測定を行なってRIST値との相関性について検討した。その結果, 両者の測定値は対照とした健康者群および気管支喘息群の場合と同様良好な相関性が認められた。4. アトピー性喘息患者の特異的減感作療法開始後, 1年以上経過を観察した症例について, 血清IgE値の変動と減感作療法の効果との関連性について検討した。その結果減感作療法有効例10例については全例, 血清IgE値の著明な下降を認めたが, 無効例8例では全例, IgE値の下降を認めないかあるいはごくわずかな下降が認められたに過ぎなかった。これらの症例におけるLog IgE値の変動幅は±0.15以内であった。有効例では全例に減感作療法開始後3.6&acd;7.9ヶ月(平均6.2±1.5ヶ月)以内にLog IgE値0.15以上の下降が認められた。

1) Serum IgE values of various respiratory diseases were measured by radio immuno sorbent test (RIST) in oder to compare with healthy control. 2) The geometric mean value of serum IgE obtained from each group of respiratory diseases was as follows; broncho-pulmonary infections (40 cases); 223 IU/ml, pulmonary tuberclosis 135 cases); 218 IU/ml, sarcoidosis (43 cases); 184 IU/ml, chronic berylliosis (5 cases); 234 IU/ml, pneumoconiosis (80 cases); 162 IU/ml, spontaneous pneumothrax (12 cases); 185 IU/ml, emphysema (16 cases); 232 IU/ml, atopic asthma (89 cases); 791 IU/ml, non-atopic asthma (32 cases); 175 IU/ml, pulmonary carcinoma (72 cases); 349 IU/ml and healthy control (215 cases); 187 IU/ml. Both mean values of serum IgE of atopic asthma and pulmonary carcinoma showed significantly higher than that of the healthy control. 3) Some of the patients, who were not atopic as far as I examined, showed apparently increased values of serum IgE. The reason was studied by paper disc radio immuno sorbent test (PRIST) which was a different system of IgE determination. The results obtained by PRIST showed a good correlation with those obtained by RIST. It is concluded that the increased values of serum IgE in these patients were not caused by "inhibitor" which was supposed by Dr. Jacobs. The cause might be attributable to abnormal regulation of IgE production which was caused by abnormality of both B-cell and T-cell system. 4) The changes of serum IgE levels of 18 cases with atopic asthma, who were all received specific-desensitization therapy, were observed the results for more than one year. "Sloping down" of serum IgE level was found in 10 cases of atopic asthma who were apparently improved by the specific-desensitization therapy. The angle index of the slope (θ) was statistically determined as -0.019 &#8805;θ&#8805;-0.042. This result suggests that a slope of serum IgE value within the range predicts the good result, which will be obtained by the desensitization treatme