Basic and clinical immunologySynergistic effects of fluticasone propionate and salmeterol on in vitro T-cell activation and apoptosis in asthma
Section snippets
Subjects
We selected 15 patients with mild intermittent asthma (age, 9-13 years), according to the criteria of the American Thoracic Society. The diagnosis of asthma and the assessment of its severity were performed at study entry according to Global Initiative for Asthma guidelines.13 None of the patients received any corticosteroid treatment during the previous 2 weeks.
The study fulfilled the criteria of the ethics committee of our hospital, and all subjects, parents, or both provided informed consent.
FP and salmeterol in combination increase apoptosis in resting PBTs
FP significantly increased PBT apoptosis in a dose-dependent manner when compared with baseline values, whereas salmeterol alone did not affect spontaneous PBT apoptosis at either tested time point. Interestingly, the combined presence of FP at all the tested concentrations and salmeterol was able to significantly increase PBT apoptosis at both time points. Moreover, FP at the concentration of 10−9 M when combined with salmeterol was not statistically different from FP at the concentration of 10
Discussion
A main goal of asthma therapy is to achieve optimal control of airway inflammation. ICSs are the mainstay of asthma management and are extremely effective inhibitors of T-cell activation7 and TH2 cytokine production.21
Previous reports demonstrated the clinical utility of combined use of glucocorticoids and LABAs in the improvement of patient symptoms and airflow limitation.10 This study shows, for the first time, a synergistic proapoptotic effect of FP and salmeterol on resting and activated T
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Supported by the Italian National Research Council and by GlaxoSmithKline.
Potential conflict of interest: E. Pace has received research support from GlaxoSmithKline. No other conflicts of interest are declared.