Mendes ES, Horvath G, Campos M, Wanner A. Rapid corticosteroid effect on beta(2)-adrenergic airway and airway vascular reactivity in patients with mild asthma.
J Allergy Clin Immunol 2007;
121:700-4. [PMID:
18086493 DOI:
10.1016/j.jaci.2007.10.038]
[Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2007] [Revised: 10/05/2007] [Accepted: 10/25/2007] [Indexed: 11/17/2022]
Abstract
BACKGROUND
Long-term glucocorticoid therapy has been suggested to improve airway and airway vascular smooth muscle responsiveness to inhaled beta(2)-agonists in patients with asthma.
OBJECTIVE
We sought to assess whether a single dose of an inhaled glucocorticoid acutely potentiates beta(2)-adrenergic airway and airway vascular smooth muscle reactivity in asthma.
METHODS
In 10 asthmatic and 10 healthy subjects, airway blood flow and FEV(1) were measured before and 30 minutes after fluticasone or placebo inhalation and 15 minutes after the subsequent inhalation of racemic albuterol (0.6 mg or 1.25 mg) or (R)-albuterol (0.3 mg or 0.6 mg).
RESULTS
In healthy subjects all albuterol formulations increased airway blood flow equally after placebo or fluticasone pretreatment. In asthmatic subjects airway blood flow response was blunted after placebo and acutely restored after fluticasone pretreatment. Fluticasone pretreatment did not increase FEV(1) responses to any albuterol formulation, except 0.6 mg racemic albuterol.
CONCLUSION
A single dose of an inhaled glucocorticoid restores beta(2)-adrenergic airway vasodilator responses in patients with mild asthma. The mechanism of this rapid glucocorticoid effect remains to be clarified.
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