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Inhaled steroids modify bronchial responses to hyperosmolar saline
L T Rodwell1, S D Anderson, J P Seale
1Dept of Respiratory Medicine, Royal Prince Alfred Hospital, Camperdown, NSW, Australia.
The European Respiratory Journal
|September 1, 1992
Summary
Inhaled beclomethasone dipropionate (BDP) significantly reduced airway sensitivity and reactivity in asthma patients. This treatment improved responses to both hyperosmolar saline and bronchoconstrictor agents like histamine.
Area of Science:
- Pulmonology
- Pharmacology
- Allergy and Immunology
Background:
- Airway hyperresponsiveness is a hallmark of asthma.
- Inhaled corticosteroids are a cornerstone therapy for asthma management.
- Understanding the impact of inhaled beclomethasone dipropionate (BDP) on airway challenges is crucial.
Purpose of the Study:
- To evaluate the effect of inhaled beclomethasone dipropionate (BDP) on airway sensitivity and reactivity.
- To assess BDP's impact on responses to both osmotic (hyperosmolar saline) and pharmacological (histamine/methacholine) challenges.
Main Methods:
- Open-label study involving 13 asthma patients.
- Airway challenges with 4.5% NaCl and histamine/methacholine performed before and after 8.8 weeks of BDP treatment (600-1,500 µg/day).
- Measurements included provocative dose causing a 20% fall in FEV1 (PD20) and airway reactivity (slope of dose-response curve).
Main Results:
- Significant reduction in airway sensitivity to 4.5% NaCl and histamine/methacholine after BDP treatment.
- Significant reduction in airway reactivity to both stimuli.
- PD20 increased 5.6-fold for 4.5% NaCl and 4.1-fold for histamine/methacholine.
- 10 of 13 patients still showed a >20% fall in FEV1 with 4.5% saline.
Conclusions:
- Inhaled beclomethasone dipropionate (BDP) effectively reduces airway sensitivity and reactivity in asthma.
- BDP demonstrates efficacy against both osmotic and pharmacological airway challenges.
- These findings support BDP's role in managing airway hyperresponsiveness in asthma.