Fluticasone propionate attenuates platelet-activating factor-induced gas exchange defects in mild asthma.
Inhaled glucocorticosteroids may reduce airway mucosal oedema in acute asthma. Inhaled platelet-activating factor (PAF) provokes pulmonary gas exchange disturbances, similar to those shown in severe asthma, which may be due to increased airway plasma leakage. This randomized, double-blind, placebo-controlled, crossover study investigated the effects of high doses of inhaled fluticasone propionate (FP) in 12 patients with mild asthma before and after PAF inhalation. Patients were studied before and 12 h after inhaling FP (6 mg) or placebo (P), and then at 5, 15 and 45 min after PAF challenge. Compared with vehicle, FP inhaled before PAF improved forced expiratory volume in one second and respiratory system resistance (Rrs), increased peripheral blood neutrophils and reduced eosinophil counts. After PAF, FP enhanced transient neutropenia at 5 min and facilitated the recovery of oxygen tension in arterial blood (FP: 93+/-4 mmHg; P: 83+/-4 mmHg) at 45 min, without influencing the increases in Rrs. In conclusion, the improvement of platelet-activated factor-induced oxygen tension in arterial blood disturbances after fluticasone proprionate suggests that inhaled glucocorticosteroids may possess vasoconstrictor properties in the pulmonary circulation.
Acuña
A A
AA
Servei de Pneumologia i Allèrgia Respiratòria, Institut Clinic de Pneumologia i Cirurgia Toracica, Hospital Clínic, Villarroel, Barcelona, Spain.
Gabrijelcic
J
J
Uribe
E M
EM
Rabinovich
R
R
Roca
J
J
Barberà
J A
JA
Chung
K F
KF
Rodriguez-Roisin
R
R
D000280:Administration, Inhalation; D000328:Adult; D000730:Androstadienes / Q000008:administration & dosage* / Q000627:therapeutic use; D001249:Asthma / Q000188:drug therapy* / Q000503:physiopathology; D001784:Blood Gas Analysis; D001993:Bronchodilator Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D018592:Cross-Over Studies; D004311:Double-Blind Method; D004347:Drug Interactions; D005260:Female; D000068298:Fluticasone; D006801:Humans; D008297:Male; D010972:Platelet Activating Factor / Q000008:administration & dosage* / Q000494:pharmacology; D011659:Pulmonary Gas Exchange / Q000187:drug effects*; D012123:Pulmonary Ventilation / Q000187:drug effects; D020545:Respiratory Mucosa / Q000098:blood supply / Q000187:drug effects; D013997:Time Factors; D016896:Treatment Outcome
D000730:Androstadienes; D001993:Bronchodilator Agents; D010972:Platelet Activating Factor; D000068298:Fluticasone