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Systemic sensitivity to corticosteroids in smokers with asthma.
E Livingston1, R Chaudhuri, A D McMahon
1Department of Respiratory Medicine, Division of Immunology, Infection and Inflammation, University of Glasgow and Western Infirmary, Glasgow, G11 6NT, UK.
The European Respiratory Journal
|August 11, 2006
Summary
Smokers with asthma show reduced skin response to topical corticosteroids, indicating corticosteroid insensitivity extends beyond airways. This impacts treatment effectiveness in this patient group.
Area of Science:
- Pulmonology
- Dermatology
- Immunology
Background:
- Asthma patients who smoke exhibit reduced sensitivity to corticosteroid therapies.
- The extent of this corticosteroid insensitivity in smokers, particularly in non-airway tissues, remains unclear.
Purpose of the Study:
- To investigate whether corticosteroid insensitivity in smokers with asthma affects tissue sites beyond the airways.
- To compare the cutaneous and peripheral blood lymphocyte responses to corticosteroids between smokers and non-smokers with and without asthma.
Main Methods:
- An observational study involving 75 asthmatic subjects (39 smokers) and 78 healthy controls (30 smokers).
- Assessed cutaneous vasoconstrictor response to topical beclometasone.
- Measured peripheral blood lymphocyte sensitivity to dexamethasone-induced suppression of phytohaemagglutinin (PHA) stimulated proliferation.
Main Results:
- Smokers with asthma demonstrated a significantly reduced cutaneous vasoconstrictor response to beclometasone compared to never-smokers with asthma.
- Overall, smokers (both asthmatic and healthy) showed a reduced vasoconstrictor response compared to never-smokers.
- Lymphocyte sensitivity to corticosteroids was comparable across all groups.
Conclusions:
- Smokers with asthma exhibit impaired cutaneous vasoconstrictor response to topical corticosteroids.
- This suggests that corticosteroid insensitivity in smokers with asthma is not limited to the airways but affects other tissue sites.