Šukriya Krvavac, Women's Health Center, Sarajevo, Bosnia-Herzegovina

Investigations in seemingly remote medical disciplines led researchers
to similar results.Searching the basic cause of astmatic bronchitis
there established the conviction that proteinases, mostly from unrecog-
nized source initiate pathogenesis of bronchial mucosal membrane:epith-
lium desquamation,denudation  and subsequent irritability of tussigenne
receptors with muscular hyperreactivity.

On the other hand, the one of three Trichomonas (T) species which colon-
ise the humans, T tenax,which unrarely inhabits upper airways, affects
tissue rather by secreting proteinases, which are the unavoidable target
of the host immune forces than by direct cyto/histo-pathogenic action.

Antiproteinases are immune answer of the host.Pseudocystic aflagellary
Ts,which are mostly present in subclinical infection phase  in sentisized
hosts,also secrete proteinases,so proving at least their immunopathogenic
potential instead of saprophytic nature. The cold of chronically infested
organs inhibits local mucosal resistence and elicits the contraction of
chilled parasites out-squeezing their proteinases and other metabolites.

The other physical and chemical factors can also initiate this event. The-
se substances cause,in sentisized host,allergic reaction in distant extra-
focal areas.

The inhalation of parasitic proteinases from the upper airways (nose,
sinuses nasopharynx,tonsils) of sensitized patient unquestionably cause
allergic reaction in lower airways. Erythema, excoriation and irritation
of perigenital area caused by exacerbation of bronic cervovaginal trich-
omoniasis are strikingly similar to perinasal appearences in cases of
cold of persons with chronic subclinical nasal infection with T tenax.

Inherent and acquired pathogenic capacity of parasites and genetically
determined host reactivity toward parasites determine the pathological
picture and clinical syndrome. Secondary bronchial colonisation with
same paraste complicates the pathologic picture,pariculary in coinfect-
ion with various bacteria, even viruses, including HIV.

PRESENTED as poster on 4th WORLD ASTHMA MEETING held in February 2004 in
Bangkok,Thailand,under auspices and sponsorship of Asthma Foundation of
Thailand,Global Initiative for Asthma,International Union Against Tuber-
culosis and Lung Diseases,American College of Chest Physicians,American
Thoracic Society,American Academy of Allergy,Asthma and Immunology,Asian
Paific Society of respirology and European Respiratory Society.
With permission:Asthma Foundation of Thailand,Suchai Charoenratanakul,MD.