Effect of ascorbic acid on the clinical course of infection-related bronchial asthma and the formation of reactive oxygen metabolites by BAL cells

References and Figures are available in the above versions. List of abbreviations AM Alveolar macrophages BAL Bronchoalveolar lavage BHR Bronchial hyperreactivity CL Chemiluminescence DCC Differential cell count ROM Reactive oxygen metabolites R AW Airway resistance (measured by occlusive pressure techniques) Summary (Authors' summary in english) Possible anti-asthmatic effectiveness of ascorbic acid was checked, in a double blind study, on patients with infection-related bronchial asthma. Basic medication to 29 outpatients was accompanied by three oral doses of 5 g/day of ascorbic acid, as compared to placebo, through 35 days. Testing periods were randomised by cross-over design with seven-day washout periods. The following parameters were investigated and were evaluated:-Daily asthma symptom score;-Four measurements per day of expiratory peak flow, throughout the entire study;-Three checks throughout study of bronchial hyperreactivity, using histamine provocation;-Broncho-alveolar lavage at the end of testing periods, with determination of alveolar differential cell count and measurement of metabolic activity of broncho-alveolar cells, using chemiluminescence;-Global assessment of effectiveness and tolerance by doctor and patient. Ascorbic acid exhibited merely poor broncholytic action. Symptom scores were slightly improved in the course of treatment, and peak flow values were slightly increased, as well. Hence, clinically relevant anti-asthmatic and, more specifically, broncholytic effects were not observed. However, bronchial hyperreactivity was reduced by uptake of ascorbic acid in 52 percent of all asthma patients involved. Alveolar differential cell count in patients with infection-related bronchial asthma was characterised by alveolar lymphocytosis. Chemiluminescence measurements were applied to alveolar macrophages and revealed reduced chemiluminescence response under the impact of ascorbic acid. These findings are likely to support the assumption that ascorbic acid, an anti-oxidant, reduced the buildup of reactive oxygen metabolites in patients with infection-related asthma and thus counteracted the inflammatory pathogenetic mechanism and, consequently, might be conducive to moderate lowering of bronchial hyperreactivity. The use of ascorbic acid for prophylactic medication on patients with bronchial hyperreactivity or mild forms of asthma appears to be a possible option, as a result of this study. Due consideration should be given to contraindications to administration of anti-oxidants, such as purulent infections. Summary (Translation from German; English translation by original authors above) The potential anti-asthmatic effectiveness of ascorbic acid was studied in patients with infection-related bronchial asthma. In addition to the basic medication, 29 outpatients were additionally treated for a period of 35 days with 5 g/day of ascorbic acid in comparison to oral placebo in 3 daily doses. The allocation of …