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Related Experiment Videos

Corticosteroid resistance in chronic asthma.

J Carmichael, I C Paterson, P Diaz

    British Medical Journal (Clinical Research Ed.)
    |May 2, 1981
    PubMed
    Summary

    Some chronic asthma patients resist oral corticosteroids. Early identification of corticosteroid-resistant asthma is crucial to avoid unnecessary side effects from long-term treatment.

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    Area of Science:

    • Pulmonology
    • Clinical Immunology
    • Pharmacology

    Background:

    • Chronic asthma management often involves oral corticosteroids for persistent airflow obstruction.
    • A subset of chronic asthma patients exhibits resistance to oral corticosteroid therapy.
    • Understanding the characteristics and mechanisms of corticosteroid resistance is vital for optimizing patient care.

    Purpose of the Study:

    • To compare clinical features between chronic asthma patients responsive to bronchodilators but resistant to oral corticosteroids and those responsive to both.
    • To identify potential predictors of oral corticosteroid resistance in chronic asthma.
    • To explore underlying mechanisms contributing to corticosteroid resistance in asthma.

    Main Methods:

    • Comparative study of 58 corticosteroid-resistant chronic asthma patients versus 58 corticosteroid-responsive chronic asthma patients.
    • Matching of groups for age and sex.
    • Assessment of clinical differences, family history, symptom duration, diurnal peak expiratory flow rate variation, and bronchial reactivity to methacholine.

    Main Results:

    • Corticosteroid-resistant asthma patients showed a more frequent family history of asthma and longer symptom duration.
    • Resistant patients exhibited lower morning peak expiratory flow rates and greater bronchial hyperreactivity to methacholine.
    • These features were also observed in some corticosteroid-responsive asthmatics, suggesting they are not definitive markers of resistance.

    Conclusions:

    • The failure of prednisolone to inhibit monocyte-mediated bronchial reactions may underlie corticosteroid resistance in some asthma patients.
    • Early identification of corticosteroid-resistant asthma is essential to discontinue ineffective oral corticosteroid treatment.
    • Avoiding unnecessary corticosteroid use in resistant patients mitigates the risk of serious treatment-related side effects.

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