Effects of steroid therapy on inflammatory cell subtypes in asthma

RationaleAirway inflammation in asthma is heterogeneous with different phenotypes. The inflammatory cell phenotype is modified by corticosteroids and smoking. Steroid therapy is beneficial in eosinophilic asthma (EA), but evidence is conflicting regarding non-eosinophilic asthma (NEA).ObjectivesTo a...

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Veröffentlicht in:	Thorax 2010-05, Vol.65 (5), p.384-390
Hauptverfasser:	Cowan, Douglas C, Cowan, Jan O, Palmay, Rochelle, Williamson, Avis, Taylor, D Robin
Format:	Artikel
Sprache:	eng
Schlagworte:	Adolescent Adult Aged Androstadienes - pharmacology Androstadienes - therapeutic use Asthma Asthma - drug therapy Asthma - pathology Asthma - physiopathology Biological and medical sciences Breath Tests - methods Bronchial Provocation Tests - methods Cardiology. Vascular system Chronic obstructive pulmonary disease, asthma Clinical trials eosinophil Eosinophils - drug effects Female Fluticasone Forced Expiratory Volume - drug effects Genotype & phenotype Glucocorticoids - pharmacology Glucocorticoids - therapeutic use Humans inflammatory cell Male Medical sciences Middle Aged neutrophil Neutrophils Neutrophils - drug effects Nitric oxide Nitric Oxide - metabolism Phenotype Pneumology Pulmonary Eosinophilia - drug therapy Pulmonary Eosinophilia - pathology Pulmonary Eosinophilia - physiopathology Respiratory Hypersensitivity - drug therapy Respiratory Hypersensitivity - pathology Respiratory Hypersensitivity - physiopathology Smoking Spirometry Sputum - cytology Steroids Young Adult
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Zusammenfassung:	RationaleAirway inflammation in asthma is heterogeneous with different phenotypes. The inflammatory cell phenotype is modified by corticosteroids and smoking. Steroid therapy is beneficial in eosinophilic asthma (EA), but evidence is conflicting regarding non-eosinophilic asthma (NEA).ObjectivesTo assess the inflammatory cell phenotypes in asthma after eliminating potentially confounding effects; to compare steroid response in EA versus NEA; and to investigate changes in sputum cells with inhaled corticosteroid (ICS).MethodsSubjects undertook ICS withdrawal until loss of control or 28 days. Those with airway hyper-responsiveness (AHR) took inhaled fluticasone 1000 μg daily for 28+ days. Cut-off points were ≥/
ISSN:	0040-6376 1468-3296
DOI:	10.1136/thx.2009.126722