Wine-induced asthma: Is sulfite the only culprit?

Wine-induced asthma: Is sulfite the only culprit?

Vally H, Carr A, El-Saleh J, Thompson P, University of Western Australia, Queen Elizabeth II Medical Centre, Perth. Wine-induced asthma: a placebo-controlled assessment of its pathogenesis. J Allergy Clin Immunol. Jan 1999;103:41-46.

The sulfites contained in wine have been implicated in wine-induced asthma, but do nonsulfite components also play a role? Perhaps, but Vally and associates were unable to demonstrate a decline in lung function following challenge with low-sulfite wine.

They studied 16 adults who had stable asthma and a history of worsening symptoms within 1 hour after wine consumption. Mean forced expiratory volume in 1 second ([FEV.sub.1]), forced expiratory flow at mid-expiratory phase ([FEF.sub.25-75]), and peak expiratory flow (PEF) were measured before and 5, 10, 15, 30, and 60 minutes after challenge with low-sulfite red or white wine and a wine placebo.

Mean [FEV.sub.1], [FEF.sub.25-75], and PEF before and after challenge were not significantly different. However, one person had a 24% decline in [FEV.sub.1] 5 minutes after challenge with low-sulfite wine (and no decline in response to placebo). Of the 10 participants who subsequently underwent challenge with high-sulfite white wine, only two had an asthmatic reaction.

The authors acknowledge that some persons may be sensitive to a component in low-sulfite red wine. One possible culprit is histamine, which is present is greater concentrations in red wine than in white wine. Other factors may be involved as well–for example, wine may potentiate the asthmatic response to environmental irritants, such as cigarette smoke.

Despite the absence of a decline in lung function, some of the participants reported changes in asthma symptoms after wine challenge. Therefore, spirometry may not be sensitive enough to detect wine-induced asthma in all persons.

COPYRIGHT 1999 Cliggott Publishing Co.

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