Objective To evaluate the effect of inhaled corticosteroids on airway remodeling in patients with mild asthma.Methods In this single-arm,open-label,singlecenter,prospective exploratory study,we enrolled patientswithmi...Objective To evaluate the effect of inhaled corticosteroids on airway remodeling in patients with mild asthma.Methods In this single-arm,open-label,singlecenter,prospective exploratory study,we enrolled patientswithmildasthma from January 2019 to December 2020 at the First Affiliated Hospita1l of Guangdong Pharmaceutical University.A total of 15 patients with mild asthma were included in this study.There were 6 males and 9 females.The age was(38.6±11.5)years.Fluticasone propionate inhalation aerosol(125μg)was administered twice daily for 12 months.Pulmonary function tests,high-resolution chest CT,asthma control test(ACT)questionnaires were performed before and after treatment.Airway mucosal biopsies and bronchoalveolarlavage fluid were obtained by bronchoscopy of the right lower lobe to evaluate the airway inflammatory condition.Airway lumen area(Ai),airway wall thickness(Aw%)measured by CT,and the thickness of airway epithelium,basement membrane and smooth muscle measured by pathology were analyzed to evaluate the effect of inhaled corticosteroid on airway remodeling.Pearson or Spearman correlation were used to analyze the correlation among the improvement in lung function,ACT score and the improvement of airway remodeling.Results The Ai at 3,4,5,and 6^(th)generation of bronchi was increased by 7.5%,14.4%,4.1%,and 22.8%,respectively;The Aw%was decreased by 6.1%,6.7%,6.5%,and 7%,respectively(all P<0.05).The average area of airway smooth muscle was 13.3%±8.7%at baseline,and was 11.67%at the 12th month(interquartile range 9%),but the change was not significant(Z=-0.63,P=0.539).The thickness of the basement membrane decreased from(5.19±1.75)μm to(3.83±1.15)μm at the 12th month(Z=-2.38,P=0.019).The thickness of the epithelium decreased from(78.60±13.12)μm to(59.32±11.97)μmat12month(t=4.20,P<0.001).Changes in Aw%,epithelial and basement membrane thickness at the 12th month were correlated with the improvement in ACT score(all P<O.05).Conclusion Regular inhalation of corticosteroids for 12 months in patients with mild asthma results in reduced airway remodeling,as evidenced by a decrease in the thickness of airway wall,airway mucosal epithelium and basementmembraneT.heimprovement of airway remodeling is significantly associated with the improvement of asthma ACT score.A scientific rationale for inhaled corticosteroids in mild asthma on airway remodeling is provided at the level of morphology and structure.展开更多
Objective: To investigate the effect of inhaled low dose corticosteroid combined with oral low dose theophylline in patients with bronchial asthma. Methods: A total of 30 cases were collected from patients with bronch...Objective: To investigate the effect of inhaled low dose corticosteroid combined with oral low dose theophylline in patients with bronchial asthma. Methods: A total of 30 cases were collected from patients with bronchial asthma in our hospital. The samples were collected during the period of 2021 1.1 to 2021 2.1. After the inclusion of the samples, the normative grouping was performed, and the comparative analysis was carried out by implementing different clinical treatment plans. They were control group (corticosteroid inhalation treatment) and observation group (low-dose corticosteroid inhalation combined with low-dose theophylline oral treatment). The efficacy difference between the two groups was analyzed. Results: Compared with the control group, the indexes of the observation group were better, and the comparison between groups showed (P 0.05). Conclusion: Inhalation of low dose corticosteroid combined with low dose theophylline is effective in the treatment of bronchial asthma.展开更多
Background： Studies of interleukin （IL）-4 and IL-6 in the exhaled breath condensate （EBC） of asthmatic patients are limited. This study was to determine the effect of inhaled corticosteroid （ICS） treatment on I...Background： Studies of interleukin （IL）-4 and IL-6 in the exhaled breath condensate （EBC） of asthmatic patients are limited. This study was to determine the effect of inhaled corticosteroid （ICS） treatment on IL-4 and IL-6 in the EBC ＆asthmatic patients. Methods： In a prospective, open-label study, budesonide 200 μg twice daily by dry powder inhaler was administered to 23 adult patients with uncontrolled asthma （mean age 42.7 years） for 12 weeks. Changes in asthma scores, lung function parameters （forced expiratory volume in 1 s [FEV1], peak expiratory flow [PEF], forced expiratory flow at 50% of forced vital capacity [FEFs0], forced expiratory flow at 75% of forced vital capacity, maximum mid-expiratory flow rate） and the concentrations of IL-4 and IL-6 in EBC were measured. Results： Both asthma scores and lung function parameters were significantly improved by ICS treatment. The mean IL-4 concentration in the EBC was decreased gradually, from 1.92 ± 0.56 pmol/L before treatment to 1.60 ± 0.36 pmolJL after 8 weeks of treatment （P 〈 0.05） and 1.54 ± 0.81 pmol/L after 12 weeks of treatment （P 〈 0.01）. However, the IL-6 concentration was not significantly decreased. The change in the IL-4 concentration was correlated with improvements in mean FEVt, PEF and FEFso values （correlation coefficients -0.468, -0.478, and -0.426, respectively）. Conclusions： The concentration of IL-4 in the EBC of asthmatic patients decreased gradually with ICS treatment. Measurement of IL-4 in EBC could be useful to monitor airway inflammation in asthmatics.展开更多
In recent years,emphasis has shifted from preventing and treating chronic obstructive pulmonary disease(COPD)to early prevention,early treatment,and disease stabilization,with the main goal of improving patients’qual...In recent years,emphasis has shifted from preventing and treating chronic obstructive pulmonary disease(COPD)to early prevention,early treatment,and disease stabilization,with the main goal of improving patients’quality of life and reducing the frequency of acute exacerbations.This review summarizes pharmacological therapies for stable COPD.展开更多
文摘Objective To evaluate the effect of inhaled corticosteroids on airway remodeling in patients with mild asthma.Methods In this single-arm,open-label,singlecenter,prospective exploratory study,we enrolled patientswithmildasthma from January 2019 to December 2020 at the First Affiliated Hospita1l of Guangdong Pharmaceutical University.A total of 15 patients with mild asthma were included in this study.There were 6 males and 9 females.The age was(38.6±11.5)years.Fluticasone propionate inhalation aerosol(125μg)was administered twice daily for 12 months.Pulmonary function tests,high-resolution chest CT,asthma control test(ACT)questionnaires were performed before and after treatment.Airway mucosal biopsies and bronchoalveolarlavage fluid were obtained by bronchoscopy of the right lower lobe to evaluate the airway inflammatory condition.Airway lumen area(Ai),airway wall thickness(Aw%)measured by CT,and the thickness of airway epithelium,basement membrane and smooth muscle measured by pathology were analyzed to evaluate the effect of inhaled corticosteroid on airway remodeling.Pearson or Spearman correlation were used to analyze the correlation among the improvement in lung function,ACT score and the improvement of airway remodeling.Results The Ai at 3,4,5,and 6^(th)generation of bronchi was increased by 7.5%,14.4%,4.1%,and 22.8%,respectively;The Aw%was decreased by 6.1%,6.7%,6.5%,and 7%,respectively(all P<0.05).The average area of airway smooth muscle was 13.3%±8.7%at baseline,and was 11.67%at the 12th month(interquartile range 9%),but the change was not significant(Z=-0.63,P=0.539).The thickness of the basement membrane decreased from(5.19±1.75)μm to(3.83±1.15)μm at the 12th month(Z=-2.38,P=0.019).The thickness of the epithelium decreased from(78.60±13.12)μm to(59.32±11.97)μmat12month(t=4.20,P<0.001).Changes in Aw%,epithelial and basement membrane thickness at the 12th month were correlated with the improvement in ACT score(all P<O.05).Conclusion Regular inhalation of corticosteroids for 12 months in patients with mild asthma results in reduced airway remodeling,as evidenced by a decrease in the thickness of airway wall,airway mucosal epithelium and basementmembraneT.heimprovement of airway remodeling is significantly associated with the improvement of asthma ACT score.A scientific rationale for inhaled corticosteroids in mild asthma on airway remodeling is provided at the level of morphology and structure.
文摘Objective: To investigate the effect of inhaled low dose corticosteroid combined with oral low dose theophylline in patients with bronchial asthma. Methods: A total of 30 cases were collected from patients with bronchial asthma in our hospital. The samples were collected during the period of 2021 1.1 to 2021 2.1. After the inclusion of the samples, the normative grouping was performed, and the comparative analysis was carried out by implementing different clinical treatment plans. They were control group (corticosteroid inhalation treatment) and observation group (low-dose corticosteroid inhalation combined with low-dose theophylline oral treatment). The efficacy difference between the two groups was analyzed. Results: Compared with the control group, the indexes of the observation group were better, and the comparison between groups showed (P 0.05). Conclusion: Inhalation of low dose corticosteroid combined with low dose theophylline is effective in the treatment of bronchial asthma.
文摘Background： Studies of interleukin （IL）-4 and IL-6 in the exhaled breath condensate （EBC） of asthmatic patients are limited. This study was to determine the effect of inhaled corticosteroid （ICS） treatment on IL-4 and IL-6 in the EBC ＆asthmatic patients. Methods： In a prospective, open-label study, budesonide 200 μg twice daily by dry powder inhaler was administered to 23 adult patients with uncontrolled asthma （mean age 42.7 years） for 12 weeks. Changes in asthma scores, lung function parameters （forced expiratory volume in 1 s [FEV1], peak expiratory flow [PEF], forced expiratory flow at 50% of forced vital capacity [FEFs0], forced expiratory flow at 75% of forced vital capacity, maximum mid-expiratory flow rate） and the concentrations of IL-4 and IL-6 in EBC were measured. Results： Both asthma scores and lung function parameters were significantly improved by ICS treatment. The mean IL-4 concentration in the EBC was decreased gradually, from 1.92 ± 0.56 pmol/L before treatment to 1.60 ± 0.36 pmolJL after 8 weeks of treatment （P 〈 0.05） and 1.54 ± 0.81 pmol/L after 12 weeks of treatment （P 〈 0.01）. However, the IL-6 concentration was not significantly decreased. The change in the IL-4 concentration was correlated with improvements in mean FEVt, PEF and FEFso values （correlation coefficients -0.468, -0.478, and -0.426, respectively）. Conclusions： The concentration of IL-4 in the EBC of asthmatic patients decreased gradually with ICS treatment. Measurement of IL-4 in EBC could be useful to monitor airway inflammation in asthmatics.
基金CAMS Innovation Fund for Medical Science,Grant/Award Number:2020-I2M-2-009National Natural Science Foundation of China,Grant/Award Number:82270038National Key Research and Development Program of China,Grant/Award Numbers:2022YFF0710800,2022YFF0710803。
文摘In recent years,emphasis has shifted from preventing and treating chronic obstructive pulmonary disease(COPD)to early prevention,early treatment,and disease stabilization,with the main goal of improving patients’quality of life and reducing the frequency of acute exacerbations.This review summarizes pharmacological therapies for stable COPD.
