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Inhaled synthetic surfactant abolishes the early allergen-induced response in asthma

Inhaled synthetic surfactant abolishes the early allergen-induced response in asthma
Inhaled synthetic surfactant abolishes the early allergen-induced response in asthma
Allergen-induced inhibition of pulmonary surfactant in asthma may promote airway oedema and consequently potentiate the severity of the asthmatic response. A randomised, single-blind, cross-over study of an inhaled synthetic phospholipid dry-powder surfactant (Pumactant) was conducted in atopic, asthmatic subjects with previously documented early and late asthmatic responses (EAR and LAR) to an inhaled allergen. This was conducted to evaluate the role of exogenous surfactant administration on EAR and LAR. A total of seven subjects had complete evaluable data and received the full dose of Pumactant.
Asthmatic subjects inhaled two separate doses of 400 mg Pumactant prior to an allergen exposure. The first dose was administered 8 h in advance and the second dose 30 min in advance. The dosage occurred through a purpose-built administration device. This was followed by a standard bronchial-provocation test, and forced expiratory volume in one second (FEV1) was measured at regular intervals over a 10-h period.
Pumactant was well tolerated and, surprisingly, abolished the EAR but not the LAR in all seven subjects. The mean area under the curve between 0–2 h (EAR) following bronchial provocation test was 0.08 for the Pumactant treatment group (PT) and 13.29 for the no treatment (NT) group. The maximum drop in FEV1 for EAR was 4.19% and 23.98% in the PT and the NT group, respectively.
The demonstration of inhibition of the early asthmatic response by exogenous surfactant, provides the first evidence that pulmonary surfactant dysfunction may also contribute to the very early asthmatic response to allergen. Exogenous surfactant administration could serve as a useful adjunct in controlling the early allergen-induced symptoms in patients with allergic asthma.
allergen provocation, asthma, asthmatic response, exogenous surfactant, pumactant
0903-1936
1046-1049
Babu, K.S.
b21f201e-3285-4943-9347-a1a3c8727a00
Woodcock, D.A.
7127ee5a-c7db-4404-909e-32e35d30b883
Smith, S.E.
c792e851-37e1-4e6d-812a-0719fb39edaf
Staniforth, J.N.
c0f2b103-c44e-46ee-9ea3-90e48f72b756
Holgate, S.T.
2e7c17a9-6796-436e-8772-1fe6d2ac5edc
Conway, J.H.
bbe9a2e4-fb85-4d4a-a38c-0c1832c32d06
Babu, K.S.
b21f201e-3285-4943-9347-a1a3c8727a00
Woodcock, D.A.
7127ee5a-c7db-4404-909e-32e35d30b883
Smith, S.E.
c792e851-37e1-4e6d-812a-0719fb39edaf
Staniforth, J.N.
c0f2b103-c44e-46ee-9ea3-90e48f72b756
Holgate, S.T.
2e7c17a9-6796-436e-8772-1fe6d2ac5edc
Conway, J.H.
bbe9a2e4-fb85-4d4a-a38c-0c1832c32d06

Babu, K.S., Woodcock, D.A., Smith, S.E., Staniforth, J.N., Holgate, S.T. and Conway, J.H. (2003) Inhaled synthetic surfactant abolishes the early allergen-induced response in asthma. European Respiratory Journal, 21 (6), 1046-1049.

Record type: Article

Abstract

Allergen-induced inhibition of pulmonary surfactant in asthma may promote airway oedema and consequently potentiate the severity of the asthmatic response. A randomised, single-blind, cross-over study of an inhaled synthetic phospholipid dry-powder surfactant (Pumactant) was conducted in atopic, asthmatic subjects with previously documented early and late asthmatic responses (EAR and LAR) to an inhaled allergen. This was conducted to evaluate the role of exogenous surfactant administration on EAR and LAR. A total of seven subjects had complete evaluable data and received the full dose of Pumactant.
Asthmatic subjects inhaled two separate doses of 400 mg Pumactant prior to an allergen exposure. The first dose was administered 8 h in advance and the second dose 30 min in advance. The dosage occurred through a purpose-built administration device. This was followed by a standard bronchial-provocation test, and forced expiratory volume in one second (FEV1) was measured at regular intervals over a 10-h period.
Pumactant was well tolerated and, surprisingly, abolished the EAR but not the LAR in all seven subjects. The mean area under the curve between 0–2 h (EAR) following bronchial provocation test was 0.08 for the Pumactant treatment group (PT) and 13.29 for the no treatment (NT) group. The maximum drop in FEV1 for EAR was 4.19% and 23.98% in the PT and the NT group, respectively.
The demonstration of inhibition of the early asthmatic response by exogenous surfactant, provides the first evidence that pulmonary surfactant dysfunction may also contribute to the very early asthmatic response to allergen. Exogenous surfactant administration could serve as a useful adjunct in controlling the early allergen-induced symptoms in patients with allergic asthma.

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Published date: 1 June 2003
Keywords: allergen provocation, asthma, asthmatic response, exogenous surfactant, pumactant

Identifiers

Local EPrints ID: 26919
URI: https://eprints.soton.ac.uk/id/eprint/26919
ISSN: 0903-1936
PURE UUID: ce98d10c-4ef8-4a01-9d56-a470ac78e123
ORCID for J.H. Conway: ORCID iD orcid.org/0000-0001-6464-1526

Catalogue record

Date deposited: 25 Apr 2006
Last modified: 19 Jul 2019 19:04

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