Acta Medica Medianae
EFFECTS OF INHALED GLUCOCORTICOSTEROIDS TREATMENT ON CLINICAL AND EOSINOPHILIC INFLAMMATORY PARAMETERS IN PATIENTS WITH BRONCHIAL ASTHMA
Saša Jovanović1, Vidosava Đorđević2 i Vladan Ćosić2
Zavod za plućne bolesti i tuberkulozu Niš1
Centar za medicinsku biohemiju Klinički centar Niš2
Inhaled glucocorticosteroids are the most efficient anti-inflamatory drugs used in asthma treatment that can bring the improvement of clinical symptoms as well as lung function. Eosinophils (Eo) are the key efector cells in asthmatic inflammation, and determination of their number and concentration of mediators which can bring about eosinophilic activation- interleukin-5 (IL-5) would contribute to the evaluation of anti-inflammatory treatment effects in asthma patients.
The aim of this study was to compare clinical parameters and eosinophilic inflammation parameters in patients with asthma, after 4-week treatment with fluticasone-propionate (FP) in a daily dose of 500 μg.
The study involved 39 patients with bronchial asthma as well as 17 healthy subjects (controls). Asthma symptom scores, FEV1, FEV1/FVC, total number of Eo in peripheral blood and IL-5 concentracion in serum were measured in all subjects, before and after FP 500 treatment.
There was a significant decrease in asthma symptom scores (p<0.001) and improvement of FEV1 and FEV1/FVC (p<0.05) after FP 500 treatment.There was also a statistically significant negative correlation beetwen asthma symptom score and FEV1 before and after the treatment (r=-0,415, p<0,01; r=-0,346, p<0,05). The concentration of eosinophilic inflammatory parameters (Eo, IL-5) was significantly reduced after the treatment (p<0.05) in groups of patients with larger number of eosinophiles prior to the therapy.
Besides lung function normalisation and improvement of disease symptoms after the treatment, there were higher concentrations of eosinophilic inflammatory parameters that point to persistant inflammation of airways during well-controlled asthma. It is necessary to constantly compare the symptoms of desease, lung function, severity of desease and level of inflammation parameters in order to assess the treatment effects of inhaled glycocortico-steroids. Acta Medica Medianae 2010;49(1):43-47.
Key words: bronchial asthma, glucocorticosteroids, inflammation, fluticasone-propionate