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Inhalation and nasal aspirin challenge has been investigated in asthma patients with co-existing rhinitis. Eight of 39 asthma patients were diagnosed as aspirin-sensitive on the basis of inhalation challenge. Seven aspirin-sensitive asthmatics were subjected to nasal aspirin provocation. During nasal challenge, all seven patients experienced a fall in FEV1 of at least 15%, two showed a significant increase (greater than 400%) in nasal airways resistance (NAR) and one developed urticaria. No significant changes in FEV1 or NAR were observed in nine normal subjects after aspirin inhalation and nasal challenge. There were no significant changes in FEV1 or NAR in six aspirin-tolerant asthmatics when aspirin was given intranasally. The results of this study show that aspirin nasal provocation impairs lung function in aspirin-sensitive asthmatics. In comparison with inhalation challenge responses are generally milder and easier to control. Nasal challenge is also less time-consuming than other methods of aspirin challenge and is therefore more suitable for routine use.

Fifty-one fish meal factory workers in four Polish harbour cities were investigated. They had been employed in the fish meal factory for 1--33 years and 10.7 years on average. All but seven of these were smokers. The investigation consisted of respiratory symptoms questionnaire, chest X-ray, physical examination, respiratory function assessment, intradermal skin tests to ten fish genera, total serum IgE and serum precipitins to fish antigen assessment. Chronic bronchitis was diagnosed in 29 investigated patients. In 12 (23%) of the patients, according to their case history or to skin tests, allergy to fish was suspected, but was confirmed by elevated serum IgE levels in only two of these. In no cases were serum precipitins against fish antigen found. In six patients, either obstructive or restrictive changes were diagnosed according to conventional spirometry, but by MEF50% VC in 17 subjects (33%) slight airways obstruction was diagnosed and can be regarded as the result of the habit of smoking. According to the performed investigation, only two workers presented a full clinical and immunological picture of allergy to fish. From the practical point of view, this type of professional activity is less dangerous than might be theoretically expected.

The in vitro release of endogenous and exogenous PgF₂α from plasma and serum proteins by aspirin and other analgesic drugs has been studied by RIA and equilibrium-dialysis techniques, respectively. Before aspirin addition, the mean plasma level of PgF₂α mesured by RIA was significantly lower in aspirin-sensitive asthma (ASA) patients (11.3 ± 6.5 pg/ml; n = 8) than in aspirin-tolerant asthma (ATA) patients (25.0 ± 11.4 pg/ml; n = 21). After aspirin addition (50 μg/ml) the mean PgF₂α level detected in plasma by RIA was higher in ASA patients (97.6 ± 5.5 pg/ml) than in ATA patients (66.9 ± 4.5). The binding of [³H]PgF₂α to serum protein was significantly inhibited by NSAIDs but not by paracetamol (0.2–1.0 mM). These results implicate PgF₂α and the protein-binding property of analgesic drugs in the pathogenesis of aspirin-sensitive asthma.