Effect of short-term treatment with low-dose inhaled fluticasone propionate on airway inflammation and remodeling in mild asthma: A placebo-controlled study
Effect of short-term treatment with low-dose inhaled fluticasone propionate on airway inflammation and remodeling in mild asthma: A placebo-controlled study
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DOI：
10.1164/ajrccm.155.6.9196087
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发表时间：
1997-06-01
影响因子：
24.7
通讯作者：
Foresi, A
中科院分区：
文献类型：
--
作者：
Olivieri, D;Chetta, A;Foresi, A
在一项双盲、平行组研究中，我们对20例仅需β 2受体激动剂控制症状的非吸烟哮喘患者进行了吸入丙酸氟替卡松（FP）短期治疗的效果检查。我们服用FP（250 μ g，每日两次）或匹配的安慰剂6周。分别于治疗前、治疗3 wk后及治疗结束时进行乙酰甲胆碱激发试验。所有患者在治疗前后均行支气管镜检查、支气管肺泡灌洗（BAL）和支气管活检。安慰剂组8例患者和FP组9例患者完成了研究。FP治疗6 wk后，支气管对乙酰甲胆碱的反应性显著降低（p < 0.05）。当我们将FP组与安慰剂组进行比较时，我们仅观察到表达细胞内粘附分子-1（ICAM-1）和MAC-1的细胞数量显著减少（分别为p < 0.04和p < 0.03）。此外，我们看到BAL中的类胰蛋白酶水平降低（p < 0.001），而嗜酸性粒细胞阳离子蛋白（ECP）水平没有显著变化。此外，FP组支气管活检标本中固有层中嗜酸性粒细胞和肥大细胞的数量显著小于安慰剂组（分别为p < 0.02和p < 0.01）。此外，在FP组中，我们发现与安慰剂组相比，基底膜厚度显著降低（p < 0.05）。总之，我们的研究结果表明，短期治疗低剂量FP减少炎症细胞浸润到固有层支气管活检标本。此外，短期低剂量FP治疗可能会控制轻度哮喘的气道重塑强度。
In a double-blind, parallel-group study, we examined the effect of short-term treatment with inhaled fluticasone propionate (FP) in a group of 20 nonsmoking asthmatic patients who required only beta(2)-agonists to control their symptoms. We administered FP (250 mu g twice daily) or matched placebo for 6 wk. Methacholine challenge was performed before treatment, after 3 wk, and at the end of treatment. Each patient underwent bronchoscopy with bronchoalveolar ravage (BAL) and bronchial biopsy before and after treatment. Eight patients in the placebo group and nine patients in the FP group completed the study. Bronchial responsiveness to methacholine decreased significantly only after 6 wk of treatment with FP (p < 0.05). When we compared the FP group with the placebo group, we observed a significant decrease only in the number of cells expressing intracellular adhesion molecule-1 (ICAM-1) and MAC-1 (p < 0.04 and p < 0.03, respectively). Moreover, we saw that the tryptase level in BAL decreased (p < 0.001), whereas the eosinophil cationic protein (ECP) level did not change significantly. Additionally, the number of eosinophils and mast cells in the lamina propria in bronchial biopsies specimens was significantly smaller in the FP group than in the placebo group (p < 0.02 and p < 0.01, respectively). Additionally, in the FP group, we found that basement-membrane thickness was significantly decreased when compared with that of the placebo group (p < 0.05). In conclusion, our results show that short-term treatment with low-dose FP reduces inflammatory cell infiltration into the lamina propria in bronchial biopsy specimens. Moreover, short-term low-dose FP treatment might control the intensity of airway remodeling in mild asthma.