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Effect of an inhaled corticosteroid on airway inflammation and symptoms in asthma.

Effect of an inhaled corticosteroid on airway inflammation and symptoms in asthma.
Effect of an inhaled corticosteroid on airway inflammation and symptoms in asthma.
The effect of inhaled corticosteroid therapy on airway mucosal inflammation was investigated in 10 symptomatic atopic asthmatic patients treated with inhaled albuterol and whose disease severity required preventative antiinflammatory treatment. Endobronchial biopsies were obtained by fiberoptic bronchoscopy before and after 6 wk of therapy with inhaled beclomethasone dipropionate (2,000 micrograms/day for 2 wk followed by 1,000 micrograms/day for 4 wk). Following treatment, there was a significant increase in mean morning peak expiratory flow (p less than 0.05) and baseline FEV1 measured on the day of methacholine challenge (p less than 0.05) and a decrease in asthma symptoms (p less than 0.01), peak expiratory flow variation (p less than 0.05), and albuterol usage (p less than 0.05). This was accompanied by a sevenfold decrease in airway responsiveness (p = 0.001). The clinical improvement in asthma was associated with a significant (p less than 0.05) reduction in epithelial and mucosal mast cells and eosinophils and submucosal T lymphocytes, but electron microscopy did not identify any changes in the extent of mast cell and eosinophil degranulation following treatment. Because of the association between the decrease in inflammatory cell numbers and the improvement in all the measured clinical and physiologic indices of asthma, we suggest that the beneficial effect of inhaled corticosteroids in asthma may be attributed to their antiinflammatory action in the bronchial mucosa.
0003-0805
669-674
Djukanović, Ratko
d9a45ee7-6a80-4d84-a0ed-10962660a98d
Wilson, John W.
f4f95a16-6be7-457f-a940-27eb45b1b883
Britten, Karen M.
fcb465c5-8415-4a75-b5b1-b994aaab3605
Wilson, Susan J.
21c6875d-6870-441b-ae7a-603562a646b8
Walls, Andrew F.
aaa7e455-0562-4b4c-94f5-ec29c74b1bfe
Roche, William R.
a5135b2d-cab5-481b-887a-78611fa00bff
Howarth, Peter H.
ff19c8c4-86b0-4a88-8f76-b3d87f142a21
Holgate, Stephen T.
2e7c17a9-6796-436e-8772-1fe6d2ac5edc
Djukanović, Ratko
d9a45ee7-6a80-4d84-a0ed-10962660a98d
Wilson, John W.
f4f95a16-6be7-457f-a940-27eb45b1b883
Britten, Karen M.
fcb465c5-8415-4a75-b5b1-b994aaab3605
Wilson, Susan J.
21c6875d-6870-441b-ae7a-603562a646b8
Walls, Andrew F.
aaa7e455-0562-4b4c-94f5-ec29c74b1bfe
Roche, William R.
a5135b2d-cab5-481b-887a-78611fa00bff
Howarth, Peter H.
ff19c8c4-86b0-4a88-8f76-b3d87f142a21
Holgate, Stephen T.
2e7c17a9-6796-436e-8772-1fe6d2ac5edc

Djukanović, Ratko, Wilson, John W., Britten, Karen M., Wilson, Susan J., Walls, Andrew F., Roche, William R., Howarth, Peter H. and Holgate, Stephen T. (1992) Effect of an inhaled corticosteroid on airway inflammation and symptoms in asthma. American Review of Respiratory Disease, 145 (3), 669-674. (doi:10.1164/ajrccm/145.3.669). (PMID:1546849)

Record type: Article

Abstract

The effect of inhaled corticosteroid therapy on airway mucosal inflammation was investigated in 10 symptomatic atopic asthmatic patients treated with inhaled albuterol and whose disease severity required preventative antiinflammatory treatment. Endobronchial biopsies were obtained by fiberoptic bronchoscopy before and after 6 wk of therapy with inhaled beclomethasone dipropionate (2,000 micrograms/day for 2 wk followed by 1,000 micrograms/day for 4 wk). Following treatment, there was a significant increase in mean morning peak expiratory flow (p less than 0.05) and baseline FEV1 measured on the day of methacholine challenge (p less than 0.05) and a decrease in asthma symptoms (p less than 0.01), peak expiratory flow variation (p less than 0.05), and albuterol usage (p less than 0.05). This was accompanied by a sevenfold decrease in airway responsiveness (p = 0.001). The clinical improvement in asthma was associated with a significant (p less than 0.05) reduction in epithelial and mucosal mast cells and eosinophils and submucosal T lymphocytes, but electron microscopy did not identify any changes in the extent of mast cell and eosinophil degranulation following treatment. Because of the association between the decrease in inflammatory cell numbers and the improvement in all the measured clinical and physiologic indices of asthma, we suggest that the beneficial effect of inhaled corticosteroids in asthma may be attributed to their antiinflammatory action in the bronchial mucosa.

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Published date: 1 March 1992

Identifiers

Local EPrints ID: 190987
URI: http://eprints.soton.ac.uk/id/eprint/190987
ISSN: 0003-0805
PURE UUID: d0c265a7-8efb-42d3-b6ff-bcb3ac0f273a
ORCID for Ratko Djukanović: ORCID iD orcid.org/0000-0001-6039-5612
ORCID for Susan J. Wilson: ORCID iD orcid.org/0000-0003-1305-8271
ORCID for Andrew F. Walls: ORCID iD orcid.org/0000-0003-4803-4595

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Date deposited: 20 Jun 2011 13:01
Last modified: 15 Mar 2024 02:39

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Contributors

Author: John W. Wilson
Author: Karen M. Britten
Author: Susan J. Wilson ORCID iD
Author: Andrew F. Walls ORCID iD
Author: William R. Roche

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