title: Effect of systemic corticosteroids on serum apoptotic markers and quality of life in patients with asthma.
abstract: Despite corticosteroids being the first line drug treatment for asthma symptom control, the mechanisms of action of corticosteroids in asthma are still poorly understood. The current study aimed to evaluate the effect of systemic corticosteroids on serum level of apoptotic markers Survivin (for inflammatory cells) and M30 apoptosense (for bronchial epithelial cells) in patients of acute exacerbation of bronchial asthma. The study involved 60 patients with acute exacerbation of bronchial asthma who were prescribed systemic corticosteroids. Patients were evaluated for their serum levels of apoptotic markers (Survivin and M30 apoptosense) and their quality of life (QOL), before and after treatment with oral prednisolone. Paired t-test was used to compare the change in the serum values. The mean baseline serum Survivin and M30 apoptosense levels were 224.10 ± 42.76 and 123.00 ± 18.79 U/L, respectively, which decreased significantly (p < 0.05) to 111.20 ± 32.26 and 29.67 ± 7.53 U/L after seven days of oral prednisolone treatment. Systemic corticosteroids also significantly improved QOL scores and peak expiratory flow rate % (PEFR%) in the asthma patients. This improvement was seen irrespective of the initial severity score. Results from the study suggest that systemic corticosteroids administration decreases the survival of inflammatory cells and increases that of bronchial epithelial cells in patients with acute exacerbation of bronchial asthma. The study has been registered with Clinical Trials Registry-India. Registry database number CTRI/2014/08/00483.
authors.affiliation: Departments of Pharmacology, Lady Hardinge Medical College & Smt. S.K. Hospital, New Delhi, India.
authors.forename: Shashikant
authors.initials: S
authors.lastname: Bhargava
authors.forename: Anupam
authors.initials: A
authors.lastname: Prakash
authors.forename: Harmeet S
authors.initials: HS
authors.lastname: Rehan
authors.forename: Lalit K
authors.initials: LK
authors.lastname: Gupta
mesh_terms: D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage / Q000627:therapeutic use*; D000328:Adult; D018927:Anti-Asthmatic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D017209:Apoptosis; D001249:Asthma / Q000097:blood* / Q000188:drug therapy* / Q000453:epidemiology; D015415:Biomarkers / Q000097:blood*; D005260:Female; D006801:Humans; D051034:Inhibitor of Apoptosis Proteins / Q000097:blood; D053538:Keratin-18 / Q000097:blood; D008297:Male; D008875:Middle Aged; D010446:Peptide Fragments / Q000097:blood; D011788:Quality of Life; D012129:Respiratory Function Tests; D000077022:Survivin; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000305:Adrenal Cortex Hormones; D018927:Anti-Asthmatic Agents; C107489:BIRC5 protein, human; D015415:Biomarkers; D051034:Inhibitor of Apoptosis Proteins; D053538:Keratin-18; C561463:M30 cytokeratin-18 peptide, human; D010446:Peptide Fragments; D000077022:Survivin