Background: Although the long-term deterioration of lung function in asthmatic patients has been described, the exact mechanism remains to be determined. Objectives: The aim of this study was to find correlations between age, sex, atopic status, duration of asthma, asthma severity and the decline in pulmonary function. Method: The medical histories of 1,006 randomly chosen asthmatic outpatients were studied and retrospective data on asthma duration, spirometry results, treatment and symptomatology were gathered. A screening spirometry was performed. Results: 598 women and 408 men (age: 44.59, range 12–95 years) participated in the study. Intermittent asthma was diagnosed in 35.4%, chronic mild asthma in 33.4%, moderate asthma in 23.8% and severe asthma in 7.45% of the patients. Statistically significant correlations between patient age, asthma duration and lung function measurements were found. Linear regression revealed the following differences in lung functions per year of asthma duration: FEV₁: –0.882% of predicted; FVC: –0.509% of predicted; FEV₁/FVC: –0.324% of predicted. The unadjusted annual decline was 80.1 ml/year (p = 0.00003) in FEV₁ and 20.5 ml/year (p = 0.036) in FVC. A multiple regression model revealed that asthma severity appears to be the strongest factor influencing pulmonary function (β = –0.55, p < 0.001 for FEV₁). Also, significant associations between pulmonary function measurements, patient age, atopic status and male sex were noted. Conclusions: The results of this large cohort study show that asthmatic patients develop a progressive decline in pulmonary function correlated with age, sex, duration of asthma and asthma severity. Early diagnosis and intervention is necessary to ameliorate any potential negative impact of asthma on lung function.

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H(1)-receptor antagonists are known to suppress reactions in skin-prick tests (SPTs); however, the effect of H(2)-receptor antagonists, which are widely used in our everyday practice, remains unclear. The aim of this study was to determine the influence of ranitidine on wheal, flare, and itching sensation in SPTs. Twenty-one atopic patients (5 women and 16 men) with an average age of 28.04 years (SD, +/-8.24) were tested with histamine, codeine, negative control solution, and standard allergen extracts. Ranitidine (150 mg daily), loratadine (10 mg daily), or placebo were given to the volunteers for 5 days in a double-blind manner with 14 days of washout period. SPTs were applied to the volar surface of a forearm. There was no difference in wheal, flare, and itching between SPTs performed after placebo and washout period. The analysis revealed a statistically significant suppression of wheal and flare by ranitidine and loratadine (p = 0.013 and <0.00001, respectively, for wheals after allergens solutions tests, Wilcoxon rank-sum test). We found a significant suppression of itching induced by ranitidine (reduction of 26.85%; p = 0.005) and loratadine (29.6%; p = 0.005) as compared with placebo (p = 0.068 versus washout). Our data show a suppressive effect of ranitidine on the wheal, flare, and itching sensation in SPT. Because the sensitivity and specificity of skin testing requires withholding medication that could change the skin reactivity, it seems important to take into account the possible influence of H(2)-receptor antagonists on allergy diagnosis and therapy.

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