Allergic broncho-pulmonary aspergillosis Clinical immunology: (2) Skin, nasal and bronchial tests


Professor J. Pepys, Department of Clinical Immunology, Institute of Diseases of the Chest, Brompton Hospital, Fulham Road, London, S.W.3.


Skin, nasal and bronchial tests with extracts of Aspergillus fumigatus and in particular with its protein fraction elicit dual. Type I plus Type III, allergic reactions in all three organs in patients suffering from allergic broncho-pulmonary aspergillosis.

The immediate asthmatic reaction is readily reversible and less severe than the late asthmatic reaction which lasts for many hours and is only temporarily reversed by the inhalation of isoprenaline. The late reaction develops slowly in contrast to the acute onset of the immediate reaction and may be accompanied by fever and leucocytosis.

The dual nasal reaction elicited in patients with allergic broncho-pulmonary aspergillosis contrasts with the production of only an immediate nasal reaction in subjects with Type I allergy and no precipitins.