Vascular component of airway remodeling in asthma is reduced by high dose of fluticasone
Vascular component of airway remodeling in asthma is reduced by high dose of fluticasone
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DOI：
10.1164/rccm.200207-710oc
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发表时间：
2003-03-01
影响因子：
24.7
通讯作者：
Olivieri, D
中科院分区：
文献类型：
--
作者：
Chetta, A;Zanini, A;Olivieri, D
我们进行了一项随机、双盲、平行组研究，以评估30例轻度至中度哮喘患者接受6周低剂量（100 μ g，每日两次）或高剂量（500 μ g，每日两次）吸入丙酸氟替卡松（FP）治疗对气道重塑血管成分的影响。我们还研究了对炎症细胞和基底膜厚度的影响，并比较了哮喘患者和8名对照受试者的支气管活检结果。治疗前后测定支气管对乙酰甲胆碱的反应性和哮喘症状评分。低剂量FIR组和高剂量FP组分别有8例患者完成研究。基线时，哮喘患者与对照组相比，血管数量和血管面积增加。哮喘患者血管数目与血管面积和肥大细胞数目相关（p <0.01）。低剂量和高剂量FP治疗后，支气管对乙酰甲胆碱的反应性、哮喘症状评分和炎性细胞均显著降低（p < 0.05）。但仅在高剂量FP后，血管数量、血管面积和基底膜厚度才减少（p < 0.05）。总之，本研究表明，在轻中度哮喘患者中，给予高剂量吸入FIR超过6周可通过减少粘膜下血管和基底膜厚度显著影响气道重塑。
We conducted a randomized, double-blind, parallel-group study to assess the effect of 6 weeks treatment with low-dose (100 mug twice a day) or high-dose (500 mug twice a day) inhaled fluticasone propionate (FP) on the vascular component of airway remodeling in 30 patients with mild to moderate asthma. We also studied the effect on the inflammatory cells and the basement membrane thickness, and we compared findings from bronchial biopsies taken in patients with asthma with those in eight control subjects. Bronchial responsiveness to methacholine and asthma symptom score were measured before and after treatments. Eight patients in the low-dose FIR group and eight patients in high-dose FP group completed the study. At baseline, patients with asthma showed an increase in the number of vessels and in vascular area as compared with control subjects. In the subjects with asthma, number of vessels correlated with vascular area (p < 0.01) and with number of mast cells (p < 0.01). Bronchial responsiveness to methacholine, asthma symptom score, and inflammatory cells decreased significantly after both low-and high-dose FP (p < 0.05). However, the number of vessels, the vascular area, and the basement membrane thickness decreased only after high-dose FP (p < 0.05). In conclusion, this study shows that in patients with mild to moderate asthma, high dose of inhaled FIR given over 6 weeks can significantly affect airway remodeling by reducing both submucosal vascularity and basement membrane thickness.