Effect of HFA-flunisolide on peripheral lung inflammation in asthma.
BACKGROUND
New hydrofluoroalkane (HFA) formulations of glucocorticoids have been shown to effectively control asthma. HFA glucocorticoids are deposited across all sizes of airways, including the small ones. However, it is not clear whether they can suppress peripheral airway inflammation.


OBJECTIVE
We sought to determine whether HFA-flunisolide could suppress peripheral inflammation in asthma.


METHODS
Twelve patients with mild to moderate asthma received HFA-flunisolide for 6 weeks. Transbronchial and endobronchial biopsy specimens were obtained before and after treatment, and spirometry was performed. Changes in inflammatory cells (eosinophils, neutrophils, lymphocytes, macrophages, basophils) and IL-5 and eotaxin were measured by using immunocytochemistry and in situ hybridization.


RESULTS
Lung function significantly improved after treatment (P <.05). HFA-flunisolide significantly reduced eosinophils, IL-5, and eotaxin in both peripheral and central airways (P <.01). Neutrophils significantly increased after treatment in peripheral and central airways (P <.05). The numbers of lymphocytes remained unchanged.


CONCLUSIONS
These results show that HFA-flunisolide effectively suppressed eosinophilic inflammation in peripheral and central airways. These changes were accompanied by improvement in lung function.
Hauber
Hans-Peter
HP
Meakins-Christie Laboratories, McGill University, Montreal, Quebec, Canada.
Gotfried
Mark
M
Newman
Kenneth
K
Danda
Rahul
R
Servi
Ronald J
RJ
Christodoulopoulos
Pota
P
Hamid
Qutayba
Q
D000328:Adult; D018927:Anti-Asthmatic Agents / Q000008:administration & dosage*; D001249:Asthma / Q000188:drug therapy* / Q000503:physiopathology; D054413:Chemokine CCL11; D019742:Chemokines, CC / Q000235:genetics; D004804:Eosinophils / Q000187:drug effects*; D005260:Female; D005446:Fluocinolone Acetonide / Q000008:administration & dosage* / Q000031:analogs & derivatives*; D006801:Humans; D006845:Hydrocarbons, Fluorinated / Q000008:administration & dosage*; D007249:Inflammation / Q000188:drug therapy*; D015848:Interleukin-5 / Q000235:genetics; D008168:Lung / Q000187:drug effects* / Q000503:physiopathology; D008297:Male; D012333:RNA, Messenger / Q000032:analysis
D018927:Anti-Asthmatic Agents; C515456:CCL11 protein, human; D054413:Chemokine CCL11; D019742:Chemokines, CC; D006845:Hydrocarbons, Fluorinated; D015848:Interleukin-5; D012333:RNA, Messenger; D005446:Fluocinolone Acetonide; C007734:flunisolide