212 Pharmacological Research, Vol. 26, Supplement 1, 19%

GAS DISTRIBUTION AND EXCHANGE IN BRONCHIAL ASTHMA

A. Ciaccia, A.L. Cogo Chair of Respiratory Diseases and Phthisiology Faculty of Medicin and Sur- gery, University of Ferrara, Italy

ASTHMA AND BACTERIAL INFECTION: ROLE OF ANTIBIOTIC THERAPY L. Allegra, M. Cazzola* Institute of Pulmonary Medicine, University, Milan, and * Institute of Pharmacology and Toxicology, Federico II University, and Division of Pneumology, A Cardarelli Hospital, Naples

Bacteria are capable both of inducing asthmatic crises and of initiating the asthmatic process. They may cause at least temporary increases in nonspecific airway responsiveness but its long-term influence is uncertain. Factors responsible for altered airway reactivity after bacterial respiratory infection are epithelial damage, airway inflammation, bacteria-induced mediator release and receptor dynamics. Antibiotic therapy has a minor but clear role in the control of acquired bronchial hyperreactivity during bacterial respiratory infections in asthmatic patients, not only by killing bacteria but also by preventing increases in bacterial histamine levels within the lung airways, or by its steroid-spating action (macrolides) or by direct antiinflammatory effect on leukocytes. However, because of airway inflammation, an antibiotic's efficacy on bronchial hyperreactivity is evident only when the inflammatory process subsides.