Release of Mast-Cell Mediators and Alterations in Lung Function in Patients with Cholinergic Urticaria

Abstract

Cholinergic urticaria was elicited in seven subjects by experimental challenge that consisted of running on a treadmill in a plastic occlusive suit. A sensation of generalized warmth of the skin was followed by pruritus, erythema, urticaria, and transient respiratory-tract symptoms consisting of shortness of breath or wheezing or both. Statistically significant falls in one-second forced-expiratory volumes (FEV¹), maximal midexpiratory flow rates (MMF), and specific conductance (SGaw) and a rise in residual volume were detected. The serum histamine concentration rose, with an augmentation of eosinophil and neutrophil chemotactic activities. Gel-filtration chromatography showed that the eosinophil chemotactic activity consisted of at least two principles. The chemotactic activities are similar in magnitude to those recognized in other skin disorders dependent on mast cells. These observations extend to the lungs the manifestations of a condition previously thought to be restricted to the skin. (N Engl J Med. 1980; 302:604–8.)