This is an open trial to assess the efficacy of BCG therapy in extrinsic asthma. There were 40 patients (M=12, F=28) with a mean age of 32 years. Some 80% had a history of allergy. A good 88% gave a family history of asthma and other allergic diseases.

On entry, the chest x-ray was essentially normal in 77%, with bronchitis in 10% and pneumonitis 7.5%. these abnormalities were treated prior to BCG therapy. BCG was administered if PPD was negative on entry and on monthly follow-up for 1 year, 30% for 1-2 years and 17% for 2-3 years. Mean BCG vaccination/year was 5.2. Patients who completed 1 year or more of follow-up and without active PTB on chest x-ray were included in the study.

Mean asthma attack/year was significantly reduced from 18.2 was significantly reduced from 18.2 ± 10.0 to 6.1 ± 4.4 pre and post-BCG therapy respectively. Likewise, mean E.R. consult/year was significantly reduced from 9.6 ± 6.9 to 1.2 ± 2.0. Based on severity of asthma, there was sign ificant improvement from entry assessment: severe-17.5%, moderate-67.5% mild-15% to post-BCG assessment: severe-0%, moderate-10.5%, mild-82.5% and asymptomatic-7.5%. Peak flow rate measured by Wright's flow meter registered insignificant increase. Individually, the result was variable: 40% improved, 35% deteriorated while 25% showed no change.

The rationale for BCG therapy's salutary effects on asthma is conjectural. We propose the immune system is re-structured from a state of high IgE production and sensitivity to a state of "normal" IgE production that is less responsive to allergens. This we believe is achieved thru BCG's enhancing effect on suppressor T-cells which in turn influence the B cells to produce a different antibody, probably IgG. The final outcome is the production of less IgE antibodies which are also less responsive to allergens.

this being an open trial, the encouraging results of the study may be apparent. future controlled randomized trials may shed light on the validity and efficacy of this inexpensive and locally available modality treatment.

There is prevailing thought that the treatment of asthma is not only challenging but frustrating as well. Since it is triggered by variety of factors, some acting independently of each other, patient and doctor alike have labelled the disease incurable for want of wonder drug that can cure it regardless of cause or causes.

It is the purpose of this paper to lift the umbra of despair and focus attention on simple, cheap and readily available mode of treatment- BCG immunotherapy.

The Filipino Family Physician, 1985 23 ( 2) pages 1-7