Acth and cortisone in allergic manifestations

In patients treated with ACTH or cortisone the skin reactions to antigens and histamine remained unchanged and it is possible that the simple titration tests do not simulate the conditions of chronic allergy and that tests devised to resemble more closely continuous allergic stimulation might show a more decisive influence of these hormones on allergic reactivity.

Abstract

1. Adrenocorticotrophic hormone and cortisone are of appreciable value in the temporary treatment of certain types and phases of allergic syndromes. They are most helpful in intractable asthma, in acute status asthmaticus, and in severe drug reactions. 2. These hormones have a number of limitations in their usefulness. The length of remissions after a single course of treatment varies from a few days to a few months, the necessity for frequent injections is a handicap, and some types of allergy do not respond. 3. ACTH and cortisone are not substitutes for more basic allergic management. 4. The dangers and hazards from continuous and sometimes from temporary use of these drugs are numerous, and the hormones must not be employed without a full understanding of their many actions. 5. In patients treated with ACTH or cortisone the skin reactions to antigens and histamine remained unchanged. 6. Quantitative studies of the ophthalmic and nasal reactions in those who have nasal and conjunctival allergy show them not to be significantly altered. 7. Sensitizing antibodies have remained unaffected after ACTH or cortisone therapy. 8. It is possible that the simple titration tests do not simulate the conditions of chronic allergy and that tests devised to resemble more closely continuous allergic stimulation might show a more decisive influence of these hormones on allergic reactivity.