Related Experiment Video

Updated: Aug 4, 2026

Fecal Glucocorticoid Analysis: Non-invasive Adrenal Monitoring in Equids
08:02

Fecal Glucocorticoid Analysis: Non-invasive Adrenal Monitoring in Equids

Published on: April 25, 2016

Short-term, high-dose, systemic steroids in children with asthma: the effect on the hypothalamic-pituitary-adrenal

L M Dolan, H H Kesarwala, J C Holroyde

    The Journal of Allergy and Clinical Immunology
    |July 1, 1987
    PubMed

    Insights

    Short-term, high-dose prednisone bursts for pediatric asthma do not significantly impair the hypothalamic-pituitary-adrenal axis (HPAA). Even with inhaled corticosteroids (IC), most children maintain normal HPAA function despite frequent prednisone use.

    Area of Science:

    • Pediatric Endocrinology
    • Respiratory Medicine
    • Pharmacology

    Background:

    • Children with chronic asthma often require short-term, high-dose prednisone bursts for exacerbations.
    • The impact of these prednisone bursts on the hypothalamic-pituitary-adrenal axis (HPAA) is not fully understood.
    • Some children also use inhaled corticosteroids (IC) for asthma control.

    Purpose of the Study:

    • To evaluate the integrity of the HPAA in children with asthma receiving short-term, high-dose prednisone bursts.
    • To determine if the frequency of prednisone bursts or concurrent use of IC affects HPAA function.

    Main Methods:

    • Assessed HPAA function by measuring plasma cortisol response to insulin-induced hypoglycemia and synthetic ACTH stimulation.
    • Compared three groups of children: infrequent prednisone bursts (Group I), frequent bursts without IC (Group II), and frequent bursts with IC (Group III).
    • All patients received daily theophylline and beta-agonists; some received sodium cromolyn. No patients received troleandomycin.

    Main Results:

    • A subnormal cortisol response to hypoglycemia was observed in 16% of Group II and 20% of Group III.
    • A subnormal cortisol response to ACTH was noted in 10% of Group III.
    • All children with subnormal responses received four or more prednisone bursts annually.

    Conclusions:

    • As a group, children with asthma treated with prednisone bursts, with or without inhaled corticosteroids, generally exhibit normal HPAA function.
    • Frequent prednisone bursts (≥4 per year) may be associated with a higher risk of subnormal HPAA response.
    • Further monitoring may be warranted for pediatric asthma patients on frequent high-dose prednisone regimens.

    More Related Videos

    Acupoint Catgut Embedding Therapy in Traditional Chinese Medicine for Managing Allergic Rhinitis03:40

    Acupoint Catgut Embedding Therapy in Traditional Chinese Medicine for Managing Allergic Rhinitis

    Published on: December 20, 2024

    Related Concept Videos

    Hypothalamic-Pituitary Axis01:37

    Hypothalamic-Pituitary Axis

    The response to stress—be it physical or psychological, acute or chronic—involves activation of the Hypothalamic-Pituitary-Adrenal (HPA) axis. The HPA axis is part of the neuroendocrine system because it involves both neuronal and hormonal communication. Its function is to regulate homeostatic systems—metabolic, cardiovascular, and immune—providing the necessary means to respond to a stressor.
    Antiasthma Drugs: β2-Adrenoceptor Agonists01:25

    Antiasthma Drugs: β2-Adrenoceptor Agonists

    Bronchodilators are critical in managing asthma, a chronic respiratory condition characterized by airway constriction due to inflammation and hyper-reactivity. Specifically, bronchodilators ease this constriction by relaxing the bronchial muscles, facilitating easier breathing.
    One class of bronchodilators includes β2-adrenoceptor agonists. These agents target the β2-adrenoceptors located on bronchial smooth muscle cells. By stimulating these receptors, β2-agonists induce relaxation in these...
    Antiasthma Drugs: Leukotriene Modifiers01:19

    Antiasthma Drugs: Leukotriene Modifiers

    Leukotriene modifiers, or cysteinyl leukotriene receptor antagonists, are medications used to manage chronic asthma. These agents target specific inflammatory mediators produced during arachidonic acid metabolism, an essential process in generating inflammation in the body.
    Leukotriene modifiers work through two distinct mechanisms:
    Antiasthma Drugs: Inhaled Corticosteroids and Glucocorticoids01:25

    Antiasthma Drugs: Inhaled Corticosteroids and Glucocorticoids

    Inhaled corticosteroids (ICS) are anti-inflammatory drugs used primarily in treating persistent asthma and providing long-term maintenance. They target the bronchial mucosa, the lining of the airways, to control inflammation, a critical factor in asthma progression and exacerbation.
    ICS work through a multifaceted mechanism of action. They suppress the inflammatory response caused by the proliferation of TH cells. They also reduce the transcription of the IL-2 gene, which is involved in the...
    Cushing Syndrome I: Introduction01:26

    Cushing Syndrome I: Introduction

    Cushing syndrome refers to the collection of clinical manifestations that arise when tissues are exposed to excessive amounts of cortisol or cortisol-like medications over an extended period. Cortisol, a glucocorticoid produced by the adrenal cortex, regulates metabolism, immune responses, and the body’s adaptation to stress. When its concentration remains chronically elevated, these physiological pathways become dysregulated, resulting in the characteristic features of the syndrome.Exogenous...
    Cushing Syndrome II: Pathophysiology01:19

    Cushing Syndrome II: Pathophysiology

    Cortisol production is normally governed by the hypothalamic–pituitary–adrenal (HPA) axis, which maintains hormonal balance through tightly regulated feedback mechanisms. Disruption of this regulatory system is central to the development of Cushing syndrome, whether the excess cortisol originates from external medications or internal pathology. Persistent cortisol elevation alters metabolism, immune function, and endocrine signaling, producing the characteristic clinical features of the...