在依赖皮质类固醇的慢性严重喘中使用环素的试验
A G Alexander1, N C Barnes, A B Kay
1Department of Allergy and Clinical Immunology, National Heart and Lung Institute, London, UK.
Lancet (London, England)
|February 8, 1992
概括
环素显著改善了慢性严重喘患者的肺功能,并减少了喘恶化. 这种免疫抑制药物通过向参与喘发病的T淋巴细胞,提供了潜在的新治疗途径.
科学领域:
- 免疫学 免疫学 免疫学
- 肺部病理学 肺部病理学
- 药理学 药理学是指药理学的学科.
背景情况:
- 对于许多患者来说,慢性严重喘治疗仍然具有挑战性.
- 在严重的喘中,皮质类固醇依赖是常见的,这表明潜在的炎症过程.
- T淋巴细胞与喘的发病有关,这表明它们是治疗点.
研究的目的:
- 评估环素在改善皮质类固醇依赖性喘患者的肺功能方面的疗效.
- 评估环素对喘恶化和疾病控制的影响.
- 在这个患者群体中调查环素的安全性和耐受性.
主要方法:
- 进行了一项随机,双盲,安慰剂控制的交叉试验.
- 33名患有长期,严重,依赖皮质类固醇的喘患者参与了这项研究.
- 患者接受了12周的环素 (5毫克/公斤/天) 或安慰剂,然后在2周的洗后进行交叉治疗.
主要成果:
- 与安慰剂相比,环素显著增加了12.0%的早晨峰值呼气流量 (PEFR) 和17.6%的1秒强迫呼气体积 (FEV1).
- 需要增加普得尼索隆剂量的喘恶化频率在使用环素时降低了48%.
- 随着循环素治疗,PEFR的日间变化减少了27.6%,并且该药物通常耐受良好.
结论:
- 环素在改善肺功能和减少严重的,依赖于皮质类固醇的喘恶化方面显示出显著的益处.
- 这些发现支持激活的T淋巴细胞在喘发病的作用.
- 用像环素这样的药物向T淋巴细胞代表了喘管理的有希望的新疗法策略.
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