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Inhaled fluticasone
  1. School of Medicine
  2. Southampton General Hospital
  3. Tremona Road
  4. Southampton SO16 6YD
  5. UK
  6. email:

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I read with interest the article on the effects of inhaled fluticasone propionate and oral prednisolone on markers of airway inflammation in asthma recently published inThorax by Meijer et al.1 In particular, it was interesting to read that the magnitude of reduction in airway hyperresponsiveness after fluticasone was more pronounced for adenosine 5′-monophosphate (AMP) than for methacholine. Ketchell et al 2 have recently reported that sensitive prediction of the AMP response to inhaled corticosteroids is already apparent as early as 48 hours. Taken together, these findings further support the use of adenosine challenge as a sensitive and convenient non-invasive test of asthmatic inflammation for potential use in diagnosis, monitoring disease activity, and evaluating treatment efficacy.3

In asthma the ability of this test to discriminate the changes in airway reactivity with anti-inflammatory treatment better than histamine or methacholine has also been validated with inhaled budesonide and the new corticosteroid ciclesonide.4 ,5 In contrast, in patients with …

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