@techreport{oai:kanazawa-u.repo.nii.ac.jp:00043726,
 month = {Dec},
 note = {I.臨床的検討
1.環境真菌Basidlomycetes属の重要性
1)従来の検討によって、重要な環境真菌としてBasldiomycetes属が同定されていたが、難治性慢性咳嗽患者の誘発喀痰中から培養された真菌のDNAシークエンスによる解析によって、我々の注目している環境真菌がBasidiomycetes属に属するBjerkanderaadusta(和名:ヤケイロタケ)であることが判明した。
2)アトピー咳嗽患者では、咽頭拭い液の爽菌培養によって、Basidiomycetes属はカンジダの次に多く(約20%)検出された。
3)Basidiomyctets属の抗原抽出液に対する即時型皮内反応の検討では、アトピー咳嗽患者では陽性率が約20%程度でり、非アトピー健常者の5%以下に比較して高率だった。
4)喀痰からBjerkandera adustaが培養同定された難治性慢性咳嗽患者8例の検討では、同真菌の抽出抗原に対するリンパ球刺激試験と抗原吸入負荷試験が陽性であったが、皮膚反応は3例のみが陽性を示し、IgE非依存性のアレルギー反応の重要性が示された。
2.アトピー咳嗽における呼気一酸化炭素(NO)濃度の検討
好酸球性気道炎症のバイオマーカーである呼気NO濃度は、喘息や咳喘息に比べて、アトピー咳嗽では低値を示した。
II.基礎的検討
1)モルモットを用いて、アトピー咳嗽と咳喘息のデルを作成し、その病態の比較を行った。アトピー咳嗽ではニューロキニンとヒスタミンが重要であるが、咳喘息ではロイコトリエンが重要であることが示された。
2)咳発作による気道への圧ストレスが咳感受性に対して増幅回路を形成することが明らかとなった。すなわち、咳嗽は強力に止めることが治療の成功に必要であることが示された。, I. Clinical research
1) Importance of environmental fungi, basidiomycetous fungi, in chronic cough
(1) In previous studies basidiomycetous fungi had been documented as important environmental fungi in severer cases of atopic cough, The DNA sequence analysis revealed that the fungi which were cultured from sputum of patients with intractable chronic cough was Bjerkandera adusta.
(2) Basidiomycetous fungi was detected from fungal culture of pharyngeal swab in 20% of patients with atopic cough. The rate was the second following Candida.
(3) We succeeded to prepare the antigen extract of basidiomycetous fungi. Immediate type skin reaction using the antigen extract solution was positive in 20% of patients with atopic cough, which was significantly higher than that (5%) in non-atopic healthy subjects.
(4) In 8 patients with intractable chronic cough whose sputum yielded Bjerkandera adusta cultured, lymphocyte stimulation test and inhalation provocation test using the fungal antigen were positive while the skin reaction was positive in only 3 patients. These findings suggest that lgE non-mediated allergic reaction is important in the fungal-associated chronic cough.
2) Exhaled nitric oxide (NO) concentration in atopic cough
Exhaled nitric oxide (NO) is a biomarker of eosinophilic airway inflammation and the levels have been shown to be elevated in bronchial asthma, cough variant asthma and non-asthmatic eosinophilic bronchitis. We investigated whether the exhaled NO levels were increased in atopic cough in comparison with those in bronchial asthma and cough variant asthma. The exhaled NO levels were significantly lower in atopic cough compared with bronchial asthma and cough variant asthma.
II. Basic research
1) We developed guinea pig models of atopic cough and cough variant asthma. Neurokinins and histamine were important in the atopic cough model while leukotrienes were important in the cough variant asthma model.
2) We hypothesized that cough attacks are mechanical stress to the airways and influence the cough reflex sensitivity. Transient rapid negative pressure was repeatedly given to anesthetized and artificially ventilated guinea pigs. Cough reflex sensitivity to inhaled capsaicin was increased 6 hours after the negative pressure stress which was associated with neutrophilic airway inflammation. Cough stress to airway makes a self-perpetuating cough-reflex cycle, in which antigen-induced increase in cough reflex sensitivity results in pathologic cough, and the cough in turn amplifies cough reflex sensitivity., 研究課題/領域番号:17607003, 研究期間(年度):2005-2007, 出典：「アトピー咳嗽におけるIgE非依存性機序と環境真菌の重要性」研究成果報告書　課題番号17607003
  (KAKEN：科学研究費助成事業データベース（国立情報学研究所）)
　　　本文データは著者版報告書より作成},
 title = {アトピー咳嗽におけるIgE非依存性機序と環境真菌の重要性},
 year = {2008}
}