Effects of inhaled budesonide on allergen-induced airway responses and airway inflammation.
Allergen inhalation by sensitized subjects results in acute bronchoconstriction, which can be followed by a later bronchoconstrictor response, allergen-induced airway hyperresponsiveness, and increases in airway inflammatory cells. Treatment with inhaled glucocorticosteroids attenuates allergen-induced asthmatic airway responses. The purpose of this study was to determine whether a 1-wk pretreatment with inhaled budesonide influences allergen-induced changes in inflammatory cells in blood and induced sputum. Seven subjects with mild atopic asthma were treated in a double-blind, placebo-controlled, randomized, crossover fashion with either inhaled budesonide 400 microg/d, or placebo for 7 d. Allergen challenges were carried out the morning after treatment was discontinued and sputum samples were obtained 7 h after allergen inhalation. Methacholine airway responsiveness was measured, and blood and sputum samples were obtained 24 h post-allergen. Budesonide treatment attenuated the magnitude of both the early and the late asthmatic response, reduced allergen-induced methacholine airway hyperresponsiveness, and attenuated allergen-induced increases in total eosinophils and activated eosinophils. These results suggest that the effects of inhaled glucocorticosteroids on allergen-induced airway responses may be mediated through their inhibition of allergen-induced eosinophil migration and activation.
Department of Medicine, McMaster University, Hamilton, Ontario, Canada.
G M
GM
Gauvreau
J
J
Doctor
R M
RM
Watson
M
M
Jordana
P M
PM
O'Byrne
D000280:Administration, Inhalation; D000328:Adult; D000485:Allergens / Q000009:adverse effects / Q000187:drug effects*; D016084:Bronchoconstriction / Q000187:drug effects; D016085:Bronchoconstrictor Agents / Q000037:antagonists & inhibitors*; D001993:Bronchodilator Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D019819:Budesonide; D004311:Double-Blind Method; D004804:Eosinophils / Q000187:drug effects; D005260:Female; D006801:Humans; D008171:Lung Diseases / Q000139:chemically induced* / Q000517:prevention & control*; D008297:Male; D016210:Methacholine Chloride / Q000037:antagonists & inhibitors*; D011282:Pregnenediones / Q000008:administration & dosage / Q000627:therapeutic use*
D000485:Allergens; D016085:Bronchoconstrictor Agents; D001993:Bronchodilator Agents; D011282:Pregnenediones; D016210:Methacholine Chloride; D019819:Budesonide