TY - JOUR
T1 - Time-dependent effects of inhaled corticosteroids on lung function, bronchial hyperresponsiveness, and airway inflammation in asthma
AU - Mehta, Vinay
AU - Stokes, Jeffrey R.
AU - Berro, Abdo
AU - Romero, Francisco A.
AU - Casale, Thomas B.
N1 - Funding Information:
Funding Sources: This study was funded by an unrestricted grant from Schering-Plough (Dr Casale).
PY - 2009/7
Y1 - 2009/7
N2 - Background: Exhaled nitric oxide (FENO) and exhaled breath condensate (EBC) are noninvasive markers that directly measure airway inflammation and may potentially be useful in assessing asthma control and response to therapy. Objective: To examine the time-dependent effects of inhaled corticosteroids on FENO and EBC markers concomitantly with lung function and bronchial hyperresponsiveness. Methods: Eleven steroid-naive adults with mild-to-moderate persistent asthma were treated with mometasone furoate dry powder inhaler, 400 μg/d, for 8 weeks, followed by a 4-week washout. Forced expiratory volume in 1 second (FEV1), the concentration of methacholine calculated to cause a 20% decline in FEV1 (PC 20), FENO, EBC pH, and EBC nitrite measurements before, during, and after treatment were analyzed and compared. Results: The mean (SEM) FEV1 increased from 3.01 (0.13) L (82% predicted) to 3.24 (0.18) L (87% predicted) by week 8 (P < .05). The PC20 level increased from 1.28 (0.31) mg/mL to 2.99 (0.51) mg/mL by treatment week 8 (P < .05) and remained relatively stable through washout week 4 (P < .05). The F ENO level decreased from 31.1 (4.1) ppb to 20.6 (4.5) ppb by treatment week 1 (P < .01), remained low through treatment week 8 (P < .01), then trended back to the baseline level by washout week 1 (P < .01). The median EBC pH increased from 7.81 (interquartile range, 7.49-8.09) to 8.02 (interquartile range, 7.87-8.12) by treatment week 4, but did not achieve statistical significance. The EBC nitrite level decreased from 17.6 (1.6) μM to 9.3 (0.9) μM by treatment week 8 (P < .01), and remained low throughout washout week 4 (P < .05). There was a negative correlation between F ENO and PC20 (Spearman rank correlation coefficient =-0.50, P < .001). Conclusion: The FENO level responded the earliest to treatment and withdrawal of inhaled corticosteroids, whereas changes in EBC markers were delayed but more sustained.
AB - Background: Exhaled nitric oxide (FENO) and exhaled breath condensate (EBC) are noninvasive markers that directly measure airway inflammation and may potentially be useful in assessing asthma control and response to therapy. Objective: To examine the time-dependent effects of inhaled corticosteroids on FENO and EBC markers concomitantly with lung function and bronchial hyperresponsiveness. Methods: Eleven steroid-naive adults with mild-to-moderate persistent asthma were treated with mometasone furoate dry powder inhaler, 400 μg/d, for 8 weeks, followed by a 4-week washout. Forced expiratory volume in 1 second (FEV1), the concentration of methacholine calculated to cause a 20% decline in FEV1 (PC 20), FENO, EBC pH, and EBC nitrite measurements before, during, and after treatment were analyzed and compared. Results: The mean (SEM) FEV1 increased from 3.01 (0.13) L (82% predicted) to 3.24 (0.18) L (87% predicted) by week 8 (P < .05). The PC20 level increased from 1.28 (0.31) mg/mL to 2.99 (0.51) mg/mL by treatment week 8 (P < .05) and remained relatively stable through washout week 4 (P < .05). The F ENO level decreased from 31.1 (4.1) ppb to 20.6 (4.5) ppb by treatment week 1 (P < .01), remained low through treatment week 8 (P < .01), then trended back to the baseline level by washout week 1 (P < .01). The median EBC pH increased from 7.81 (interquartile range, 7.49-8.09) to 8.02 (interquartile range, 7.87-8.12) by treatment week 4, but did not achieve statistical significance. The EBC nitrite level decreased from 17.6 (1.6) μM to 9.3 (0.9) μM by treatment week 8 (P < .01), and remained low throughout washout week 4 (P < .05). There was a negative correlation between F ENO and PC20 (Spearman rank correlation coefficient =-0.50, P < .001). Conclusion: The FENO level responded the earliest to treatment and withdrawal of inhaled corticosteroids, whereas changes in EBC markers were delayed but more sustained.
UR - http://www.scopus.com/inward/record.url?scp=67650369582&partnerID=8YFLogxK
U2 - 10.1016/S1081-1206(10)60140-8
DO - 10.1016/S1081-1206(10)60140-8
M3 - Article
C2 - 19663124
AN - SCOPUS:67650369582
SN - 1081-1206
VL - 103
SP - 31
EP - 37
JO - Annals of Allergy, Asthma and Immunology
JF - Annals of Allergy, Asthma and Immunology
IS - 1
ER -