[The effect of climatic and meteorologic factors on bronchial hyperreactivity and the course of bronchial asthma diseases and their potential significance in asthma prevention: hypotheses, methodologic approaches and initial results].

Abstract

Bronchial hyperresponsiveness (BHR) as the main condition for the development of asthma may be modulated either by intrinsic or by extrinsic stimuli as well as by climatic and meteorologic factors. Proinflammatory mediators in combination with alterations of airway mucosa induce or amplify BHR. Upper airway viral infections, exposure to allergens in atopic subjects, chronic hyperplastic changes of the upper airways, airway irritants and analgesics are supposed to be the most likely asthma triggers in predisposed children and adults. There is the suggestion that BHR can be improved not only by treatment with steroidal and nonsteroidal antiinflammatory drugs but also by maritime climatotherapy. The latter could be the result not only of the reduction of inhalative irritants, e.g. of allergen concentration, but also by the involvement or more complex mechanisms. Possible theoretic approaches and hypotheses regarding the mode of action of maritime climatic cures are discussed. First preliminary results obtained in a mediterranean region have demonstrated a negative impact of metereologic events like passages of cold weather fronts or increase of wind velocity on the course of asthma disease. An improvement of BHR assessed by histamine challenge test has been observed at the end of climatotherapy in the Baltic sea area. Prospective studies about asthma prevention in subjects at risk with BHR and atopy that have been starting should contribute to the evaluation of the therapeutic effects and the prognostic importance of maritime climatotherapy for getting exact scientific indications for climatotherapy in patients with bronchial asthma.