Differential effects of inhaled budesonide and oral prednisolone on serum immunoglobulin G and its subclasses in healthy adult volunteers.
BACKGROUND
Glucocorticosteroid (GCS) treatment lowers serum IgG and IgG subclass (IgG-SC) levels, but the minimal dose and duration of administration at which this occurs is not known.


OBJECTIVE
The aim of this study was to define the daily dose of a 2-week course of GCS at which IgG(-SC) suppression occurs.


METHODS
The effects of three GCS treatment schemes on serum IgG(-SC) levels in healthy adults were studied in a double-blind, randomized trial. Group 1 (n = 10) was treated with 40 mg oral prednisolone/day, group 2 (n = 10) with 10 mg oral prednisolone/day and group 3 (n = 10) with 3.2 mg inhaled budesonide/day. Blood sampling was performed at baseline and at the end of the 2-week treatment period.


RESULTS
In group 1, IgG1, IgG2 and IgG3 levels were significantly decreased after treatment, while in group 2 this was only so for IgG3. In both groups, the decrease of total IgG tended towards or just reached significance. In group 3, no statistically significant changes were observed.


CONCLUSIONS
A course of 40 mg oral prednisolone/day for 2 weeks induces significant suppression of serum IgG-SC levels; lower doses cause more subtle changes, indicating that GCS-induced IgG-SC suppression is a dose-dependent phenomenon. Short courses of very high doses of inhaled budesonide appear to be devoid of this side-effect.
Van Schoor
J
J
Department of Respiratory Disease, University Hospital, Ghent, Belgium.
Toogood
J H
JH
Pauwels
R A
RA
D000280:Administration, Inhalation; D000284:Administration, Oral; D000328:Adult; D001993:Bronchodilator Agents / Q000008:administration & dosage / Q000494:pharmacology; D019819:Budesonide; D004311:Double-Blind Method; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood* / Q000145:classification / Q000187:drug effects*; D011239:Prednisolone / Q000008:administration & dosage* / Q000009:adverse effects* / Q000494:pharmacology*; D011282:Pregnenediones / Q000008:administration & dosage* / Q000009:adverse effects / Q000494:pharmacology*
D001993:Bronchodilator Agents; D007074:Immunoglobulin G; D011282:Pregnenediones; D019819:Budesonide; D011239:Prednisolone