Immunologic responses to an adrenocorticotropic hormone preparation in bronchial asthma and rheumatoid arthritis

Thirty-three patients with bronchial asthma, including 15 atopic patients, 24 patients with rheumatoid arthritis, and 18 control subjects received intramuscular injections of a porcine ACTH preparation as antigen at weekly intervals. Intradermal testing was performed prior to each intramuscular injection with 1:10, 1:100, and 1:1,000 dilutions of ACTH preparation. In addition to immediate wheal and flare skin reactivity, another skin reactivity which we tentatively called “late skin reaction” appeared during the course of immunization. The immediate reaction developed in 75 per cent of the subjects within 8 weeks. Positive immediate reactions to 1:1,000 ACTH were observed more frequently in atopic asthma patients (in 13 of 15) than in the other subjects (p < 0.05). Follow-up observation revealed that 7 of 8 atopic patients and 7 of 21 nonatopic patients still retained immediate skin reactivity even after 4 years. The “late skin reactivity” appeared in 4 of 24 asthmatic patients, 6 of 19 rheumatoid arthritis patients, and 1 of 16 control subjects. Group differences in this reactivity were not significant.