Asthma, rhinitis, other respiratory diseasesAirway mast cells and eosinophils correlate with clinical severity and airway hyperresponsiveness in corticosteroid-treated asthma☆,☆☆
Section snippets
Subjects
Twenty nonsmoking adults (10 women) with a wide range of asthma severity participated in this study (Table I).Subject No. Age (y) Allergy* Asthma duration (y) Inhaled steroid (μg/d) FEV1 (% predicted) PD20 (μmol) 1 67 2 11 2000† 97 0.10 2 49 11 10 1500† 89 0.08 3 51 4 30 2000† 93 2.31 4 59 0 3 2000 81 0.33 5 37 3 11 2000 84 0.51 6 44 9 15 400 74 0.18 7 41 4 11‡ 2000† 84 0.02 8 31 3 21‡ 0† 98 0.05 9 39 8 8 1000 73 0.50 10 29 5 13‡ 400† 79 0.08 11 36 6 20‡ 400† 88 0.12 12 33 0 14‡ 250† 89 0.49 13 34 3 1 1000 106 13.70 14 37 4 8‡ 2000† 93 2.94 15 50 0 4 2000 81 3.27 16 65 6
RESULTS
At the completion of high-dose inhaled corticosteroid therapy, clinical asthma scores were rated as severe in 9 subjects, moderate in 6 subjects, and mild in 4 subjects (Table II).Many (60%) of the subjects had persisting methacholine airway hyperresponsiveness, with an absent plateau response (80%) and increased variability of peak expiratory flow (Table II). Most subjects (12, 60%) also had persisting hyperresponsiveness to the indirect-acting stimulus hypertonic saline solution. Clinical
DISCUSSION
This study evaluates the relationship among airway inflammation, airway hyperresponsiveness, and clinical asthma severity in corticosteroid-treated asthma. We assessed airway inflammation in 2 distinct compartments, the epithelium and the lumen, in subjects treated with a standardized optimal course of treatment with an inhaled corticosteroid. We then assessed the clinical severity of asthma by a composite score as recommended in current management guidelines. Our results indicate that in
Acknowledgements
We thank Gaye Sheather for administrative assistance and Joy Hopkins for technical assistance.
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Cited by (0)
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Supported by the National Health and Medical Research Council of Australia and the Asthma Foundation of New South Wales.
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Reprint requests: Peter G. Gibson, MBBS, FRACP, Airways Research Centre, Department of Respiratory Medicine, John Hunter Hospital, Locked Bag 1, Hunter Mail Centre Newcastle, NSW, Australia 2310.