BACKGROUND: Severe asthma occurs in a heterogeneous group of patients in whom symptoms and airway inflammation persist despite maximal antiasthma treatment. OBJECTIVE: To verify whether a short-term course of oral steroids would modify sputum inflammatory cytokine and sputum eosinophil concentrations and whether this effect is related to the presence of sputum eosinophilia. METHODS: In 59 patients with severe refractory asthma, we measured pulmonary function and inflammatory markers in hypertonic saline-induced sputum before and after 2 weeks of treatment with 0.5 mg/kg of oral prednisone (n = 39) or placebo (n = 20) daily. Selected sputum portions were assayed for total and differential cell counts and supernatant interleukin (IL) 5 and IL-8 concentrations. RESULTS: At baseline, no statistical differences were found among placebo- and prednisone-treated patients in terms of sputum inflammatory cell percentages and IL-5 and IL-8 concentrations. After treatment, forced expiratory volume in 1 second significantly increased and sputum eosinophil percentages and IL-5 and IL-8concentrations significantly decreased in the prednisone group, whereas no changes were observed in the placebo group. The positive effect of prednisone treatment was observed only in patients with baseline sputum eosinophilia, whereas in noneosinophilic patients with severe asthma prednisone induced only a significant decrease of sputum IL-8. CONCLUSIONS: Additional high-dose oral corticosteroids improve pulmonary function and reduce not only sputum eosinophil but also sputum proinflammatory cytokine concentrations in patients with severe refractory asthma.
RCT Entities:
BACKGROUND: Severe asthma occurs in a heterogeneous group of patients in whom symptoms and airway inflammation persist despite maximal antiasthma treatment. OBJECTIVE: To verify whether a short-term course of oral steroids would modify sputum inflammatory cytokine and sputum eosinophil concentrations and whether this effect is related to the presence of sputum eosinophilia. METHODS: In 59 patients with severe refractory asthma, we measured pulmonary function and inflammatory markers in hypertonicsaline-induced sputum before and after 2 weeks of treatment with 0.5 mg/kg of oral prednisone (n = 39) or placebo (n = 20) daily. Selected sputum portions were assayed for total and differential cell counts and supernatant interleukin (IL) 5 and IL-8 concentrations. RESULTS: At baseline, no statistical differences were found among placebo- and prednisone-treated patients in terms of sputum inflammatory cell percentages and IL-5 and IL-8 concentrations. After treatment, forced expiratory volume in 1 second significantly increased and sputum eosinophil percentages and IL-5 and IL-8 concentrations significantly decreased in the prednisone group, whereas no changes were observed in the placebo group. The positive effect of prednisone treatment was observed only in patients with baseline sputum eosinophilia, whereas in noneosinophilic patients with severe asthmaprednisone induced only a significant decrease of sputum IL-8. CONCLUSIONS: Additional high-dose oral corticosteroids improve pulmonary function and reduce not only sputum eosinophil but also sputum proinflammatory cytokine concentrations in patients with severe refractory asthma.
Authors: Wendy C Moore; Annette T Hastie; Xingnan Li; Huashi Li; William W Busse; Nizar N Jarjour; Sally E Wenzel; Stephen P Peters; Deborah A Meyers; Eugene R Bleecker Journal: J Allergy Clin Immunol Date: 2013-12-09 Impact factor: 10.793
Authors: W Gerald Teague; Monica G Lawrence; Debbie-Ann T Shirley; Andrea S Garrod; Stephen V Early; Jackie B Payne; Julia A Wisniewski; Peter W Heymann; James J Daniero; John W Steinke; Deborah K Froh; Thomas J Braciale; Michael Ellwood; Drew Harris; Larry Borish Journal: J Allergy Clin Immunol Pract Date: 2019-01-14
Authors: Natalia Celejewska-Wójcik; Krzysztof Wójcik; Maria Ignacak-Popiel; Adam Ćmiel; Katarzyna Tyrak; Anna Gielicz; Aleksander Kania; Paweł Nastałek; Marek Sanak; Lucyna Mastalerz Journal: Allergy Date: 2020-01-28 Impact factor: 13.146