Prednisone blunts airway neutrophilic inflammatory response due to ozone exposure in asthmatic subjects

Respiration. 2007;74(1):61-8. doi: 10.1159/000096078. Epub 2006 Oct 4.

Abstract

Background: The effect of corticosteroids on the ozone (O3)-induced airway inflammation is still debated.

Objective: The aim of the study was to confirm the effect of a short-term treatment with oral glucocorticosteroids on O3-induced airway inflammation, detected by induced sputum analysis, and on functional response in glucocorticosteroid-naive subjects.

Methods: A randomized, placebo-controlled study using oral prednisone (25 mg o.d. for 4 days) was carried out. Nine mild persistent asthmatics were exposed for 2 h, on separatedays, to 0.27 ppm O3 and to air in random order, after 4 days of treatment with prednisone (25 mg o.d.) and after 4 days of placebo.Before and after exposure, pulmonary function test was measured; 6 h afterexposure, sputum induction was done.

Results: Oral glucorticosteroids did not prevent pulmonary function decrement due to O3. After placebo, the percentage of neutrophils in induced sputum was significantly higher after O3 than after air [52.1 (15.7-77.3) vs. 17.8 (1.7-58.4), p=0.02, O3 vs. air]. This difference was lost after 4 days of treatment with prednisone [35.2% (10-96.2) vs. 30.9% (6.1-75.6), n.s., O3 vs. air]. Neutrophil elastase in sputum supernatant increased after O3 exposure in the sample obtained after placebo, but not after prednisone treatment.

Conclusions: This study confirms that glucocorticosteroids reduce inflammatory airway response, but do not prevent the airway functional impairment after O3 exposure.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Administration, Inhalation
  • Administration, Oral
  • Adult
  • Asthma / drug therapy*
  • Asthma / pathology
  • Bronchitis / chemically induced
  • Bronchitis / drug therapy
  • Bronchitis / pathology*
  • Female
  • Follow-Up Studies
  • Glucocorticoids / administration & dosage
  • Glucocorticoids / therapeutic use*
  • Humans
  • Leukocyte Elastase / metabolism
  • Male
  • Neutrophils / drug effects*
  • Neutrophils / enzymology
  • Neutrophils / pathology
  • Oxidants, Photochemical / administration & dosage
  • Oxidants, Photochemical / adverse effects*
  • Ozone / administration & dosage
  • Ozone / adverse effects*
  • Prednisone / administration & dosage
  • Prednisone / therapeutic use*
  • Single-Blind Method
  • Sputum / cytology
  • Sputum / enzymology
  • Treatment Outcome

Substances

  • Glucocorticoids
  • Oxidants, Photochemical
  • Ozone
  • Leukocyte Elastase
  • Prednisone