Effect of inhaled budesonide on lung function and airway inflammation : Assessment by various inflammatory markers in mild asthma

• Published in: American journal of respiratory and critical care medicine 1999, Vol.159 (1), p.22-30
• Main Authors: LIM, S, JATAKANON, A, JOHN, M, GILBEY, T, O'CONNOR, B. J, KIAN FAN CHUNG, BARNES, P. J
• Format: Article
• Language: English
• Subjects: Administration, Inhalation; Adult; Asthma - diagnosis; Asthma - drug therapy; Asthma - physiopathology; Biological and medical sciences; Bronchi - drug effects; Bronchi - pathology; Bronchitis - drug therapy; Bronchitis - pathology; Bronchoconstrictor Agents; Bronchodilator Agents - administration & dosage; Bronchodilator Agents - therapeutic use; Budesonide - administration & dosage; Budesonide - therapeutic use; Cross-Over Studies; Double-Blind Method; Eosinophils - pathology; Female; Forced Expiratory Volume - drug effects; Humans; Lung - drug effects; Lung - physiopathology; Male; Medical sciences; Methacholine Chloride; Peak Expiratory Flow Rate - drug effects; Pharmacology. Drug treatments; Respiratory system
• ISSN: 1073-449X; 1535-4970
• DOI: 10.1164/ajrccm.159.1.9706006

In a double-blind, cross-over study, we examined the effect of inhaled budesonide (800 microgram twice daily via Turbohaler) on lung function and various markers of airway inflammation including airway responsiveness to methacholine (PC20), exhaled nitric oxide (NO), eosinophils in induced sputum, bronchoalveolar lavage (BAL), and airway biopsies from 14 patients with mild asthma needing beta2- agonist therapy only. After inhaled steroids, there was a significant increase in FEV1 and PC20, and reduction in exhaled NO. Eosinophils in induced sputum and airway biopsy sections were also significantly decreased, although BAL eosinophil counts remained unchanged. At baseline, significant correlations were observed between exhaled NO and PC20 methacholine (r = 0.64, p < 0.05), exhaled NO and peak expiratory flow rate (PEFR) variability (r = 0. 65, p < 0.05), sputum eosinophils and FEV1 (r = -0.63, p = 0.05), and sputum eosinophils and log PC20 methacholine (r = -0.67, p < 0. 05). After treatment with inhaled steroids, there was a significant correlation between eosinophils in biopsy sections, and BAL, with log PC20 methacholine. It is likely that these parameters represent different aspects of the inflammatory process, which are all inhibited by inhaled steroids.