The effect of two months of treatment with inhaled budesonide on bronchial responsiveness to histamine and house-dust mite antigen in asthmatic children.
We studied the effect of 2 months of treatment with budesonide (BUD) (Pulmicort), an inhaled corticosteroid, on the bronchial hyperresponsiveness to house-dust mite antigen (BHR-HDM) and to histamine (BHR-H). We also investigated whether BUD started 20 to 24 h after the development of a late asthmatic reaction (LAR) would influence the antigen-induced increase in nonspecific bronchial hyperresponsiveness to BHR-H. Thirty-one children with mild asthma who were atopic to HDM were randomized double blind into two parallel groups. Fifteen patients inhaled 0.2 mg BUD three times a day. Sixteen inhaled placebo in a similar way. Treatment began 20 to 24 h after antigen exposure and continued for 2 months. BHR-H and BHR-HDM were measured prior to and at the end of treatment. BHR-H was also determined 3 days after each antigen provocation. In the children receiving BUD, mean BHR-H and mean BHR-HDM were decreased approximately twofold after 2 months. No increase in BHR-H was observed after 3 days in the BUD group, irrespective of whether a LAR occurred. In patients in whom BUD treatment was withheld after the second antigen provocation, the protective effect of BHR-H was abolished. We conclude that 2 months of treatment with an inhaled corticosteroid causes a decrease in BHR-H and BHR-HDM. When an inhaled corticosteroid is administered 20 to 24 h after antigen provocation, It may protect against the antigen-induced increase in BHR-H. After treatment is discontinued, the protective effect wears off rapidly.
De Baets
F M
FM
Erasmus University, Rotterdam, The Netherlands.
Goeteyn
M
M
Kerrebijn
K F
KF
D000280:Administration, Inhalation; D000287:Administration, Topical; D000293:Adolescent; D000818:Animals; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D000941:Antigens; D001249:Asthma / Q000188:drug therapy* / Q000503:physiopathology; D001980:Bronchi / Q000187:drug effects / Q000503:physiopathology*; D019819:Budesonide; D002648:Child; D005260:Female; D005938:Glucocorticoids; D006632:Histamine; D006801:Humans; D008297:Male; D008925:Mites / Q000276:immunology; D011282:Pregnenediones / Q000008:administration & dosage* / Q000627:therapeutic use
D000893:Anti-Inflammatory Agents; D000941:Antigens; D005938:Glucocorticoids; D011282:Pregnenediones; D019819:Budesonide; D006632:Histamine