Is low dose inhaled corticosteroid therapy as effective for inflammation and remodeling in asthma? A randomized, parallel group study

Baraket, M; Oliver, BGG; Burgess, JK; Lim, S; King, GG; Black, JL

Is low dose inhaled corticosteroid therapy as effective for inflammation and remodeling in asthma? A randomized, parallel group study

Baraket, M Oliver, BGG

Burgess, JK Lim, S King, GG Black, JL

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Publication Type:: Journal Article
Citation:: Respiratory Research, 2012, 13
Issue Date:: 2012-02-02

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Field	Value	Language
dc.contributor.author	Baraket, M	en_US
dc.contributor.author	Oliver, BGG https://orcid.org/0000-0002-7122-9262	en_US
dc.contributor.author	Burgess, JK	en_US
dc.contributor.author	Lim, S	en_US
dc.contributor.author	King, GG	en_US
dc.contributor.author	Black, JL	en_US
dc.date.available	2012-02-02	en_US
dc.date.issued	2012-02-02	en_US
dc.identifier.citation	Respiratory Research, 2012, 13	en_US
dc.identifier.issn	1465-9921	en_US
dc.identifier.uri	http://hdl.handle.net/10453/28534
dc.description.abstract	Background: While most of the clinical benefits of inhaled corticosteroid (ICS) therapy may occur at low doses, results of dose-ranging studies are inconsistent. Although symptom/lung function response to low and high dose ICS medication is comparable, it is uncertain whether low dose ICSs are as effective as high dose in the treatment of inflammation and remodeling.Methods: 22 mild or moderate asthmatic adult subjects (corticosteroid free for > 2 months) participated in a randomized, parallel group study to compare effects of fluticasone propionate (FP) 200 mcg/day and 1000 mcg/day. Alveolar macrophage (AM)-derived cytokines and basement membrane thickness (BMT) were measured at baseline and after 7 weeks treatment while symptoms, spirometry, exhaled nitric oxide (eNO) and airway hyperresponsiveness (AHR) to mannitol at baseline and 6 weeks.Results: FP improved spirometry, eNO, symptoms and AHR with no difference between low and high dose FP. Both high and low dose FP reduced GM-CSF, TNF-alpha and IL-1ra, with no change in BMT and with no differences between low and high dose FP.Conclusions: 200 μg/day of FP was as effective as 1000 μg/day in improving asthma control, airway inflammation, lung function and AHR in adults in the short term. Future studies should examine potential differential effects between low and high dose combination therapy (ICS/long acting beta agonist) on inflammation and airway remodeling over longer treatment periods. © 2012 Baraket et al; licensee BioMed Central Ltd.	en_US
dc.relation.ispartof	Respiratory Research	en_US
dc.relation.isbasedon	10.1186/1465-9921-13-11	en_US
dc.subject.classification	Respiratory System	en_US
dc.subject.mesh	Lung	en_US
dc.subject.mesh	Basement Membrane	en_US
dc.subject.mesh	Macrophages, Alveolar	en_US
dc.subject.mesh	Humans	en_US
dc.subject.mesh	Asthma	en_US
dc.subject.mesh	Inflammation	en_US
dc.subject.mesh	Nitric Oxide	en_US
dc.subject.mesh	Mannitol	en_US
dc.subject.mesh	Androstadienes	en_US
dc.subject.mesh	Anti-Asthmatic Agents	en_US
dc.subject.mesh	Cytokines	en_US
dc.subject.mesh	Breath Tests	en_US
dc.subject.mesh	Respiratory Function Tests	en_US
dc.subject.mesh	Administration, Inhalation	en_US
dc.subject.mesh	Adolescent	en_US
dc.subject.mesh	Adult	en_US
dc.subject.mesh	Female	en_US
dc.subject.mesh	Male	en_US
dc.subject.mesh	Young Adult	en_US
dc.subject.mesh	Airway Remodeling	en_US
dc.subject.mesh	Fluticasone	en_US
dc.title	Is low dose inhaled corticosteroid therapy as effective for inflammation and remodeling in asthma? A randomized, parallel group study	en_US
dc.type	Journal Article
utslib.citation.volume	13	en_US
utslib.for	1103 Clinical Sciences	en_US
utslib.for	1102 Cardiorespiratory Medicine and Haematology	en_US
pubs.embargo.period	Not known	en_US
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Science
pubs.organisational-group	/University of Technology Sydney/Faculty of Science/School of Life Sciences
pubs.organisational-group	/University of Technology Sydney/Strength - CHT - Health Technologies
utslib.copyright.status	closed_access
pubs.publication-status	Published	en_US
pubs.volume	13	en_US

Abstract:

Background: While most of the clinical benefits of inhaled corticosteroid (ICS) therapy may occur at low doses, results of dose-ranging studies are inconsistent. Although symptom/lung function response to low and high dose ICS medication is comparable, it is uncertain whether low dose ICSs are as effective as high dose in the treatment of inflammation and remodeling.Methods: 22 mild or moderate asthmatic adult subjects (corticosteroid free for > 2 months) participated in a randomized, parallel group study to compare effects of fluticasone propionate (FP) 200 mcg/day and 1000 mcg/day. Alveolar macrophage (AM)-derived cytokines and basement membrane thickness (BMT) were measured at baseline and after 7 weeks treatment while symptoms, spirometry, exhaled nitric oxide (eNO) and airway hyperresponsiveness (AHR) to mannitol at baseline and 6 weeks.Results: FP improved spirometry, eNO, symptoms and AHR with no difference between low and high dose FP. Both high and low dose FP reduced GM-CSF, TNF-alpha and IL-1ra, with no change in BMT and with no differences between low and high dose FP.Conclusions: 200 μg/day of FP was as effective as 1000 μg/day in improving asthma control, airway inflammation, lung function and AHR in adults in the short term. Future studies should examine potential differential effects between low and high dose combination therapy (ICS/long acting beta agonist) on inflammation and airway remodeling over longer treatment periods. © 2012 Baraket et al; licensee BioMed Central Ltd.

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http://hdl.handle.net/10453/28534