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Titolo:
Beclomethasone diproprionate reduced airway inflammation without adrenal suppression in young children with cystic fibrosis: A pilot study
Autore:
Wojtczak, HA; Kerby, GS; Wagener, JS; Copenhaver, SC; Gotlin, RW; Riches, DWH; Accurso, FJ;
Indirizzi:
Childrens Hosp, Pulm Sect, Denver, CO 80218 USA Childrens Hosp Denver CO USA 80218 Hosp, Pulm Sect, Denver, CO 80218 USA USN, Med Ctr, Dept Pediat, Div Pulm Med, San Diego, CA 92152 USA USN San Diego CA USA 92152 Pediat, Div Pulm Med, San Diego, CA 92152 USA Univ Colorado, Hlth Sci Ctr, Dept Pediat, Denver, CO 80262 USA Univ Colorado Denver CO USA 80262 Ctr, Dept Pediat, Denver, CO 80262 USA Mike McMorris Cyst Fibrosis Res & Treatment Ctr, Denver, CO USA Mike McMorris Cyst Fibrosis Res & Treatment Ctr Denver CO USA er, CO USA Texas A&M Univ, Hlth Sci Ctr, Dept Pediat, Div Pulm Med, Temple, TX USA Texas A&M Univ Temple TX USA , Dept Pediat, Div Pulm Med, Temple, TX USA Scott & White Mem Hosp & Clin, Temple, TX USA Scott & White Mem Hosp & Clin Temple TX USA Hosp & Clin, Temple, TX USA Natl Jewish Med & Res Ctr, Dept Pediat, Div Basic Sci, Denver, CO USA NatlJewish Med & Res Ctr Denver CO USA t, Div Basic Sci, Denver, CO USA Univ Colorado, Hlth Sci Ctr, Dept Med, Div Pulm Sci, Denver, CO 80262 USA Univ Colorado Denver CO USA 80262 Med, Div Pulm Sci, Denver, CO 80262 USA Univ Colorado, Hlth Sci Ctr, Dept Biochem & Mol Genet, Denver, CO USA UnivColorado Denver CO USA tr, Dept Biochem & Mol Genet, Denver, CO USA Univ Colorado, Hlth Sci Ctr, Dept Immunol, Denver, CO USA Univ Colorado Denver CO USA , Hlth Sci Ctr, Dept Immunol, Denver, CO USA Univ Colorado, Hlth Sci Ctr, Dept Pharmacol, Denver, CO 80262 USA Univ Colorado Denver CO USA 80262 r, Dept Pharmacol, Denver, CO 80262 USA
Titolo Testata:
PEDIATRIC PULMONOLOGY
fascicolo: 4, volume: 32, anno: 2001,
pagine: 293 - 302
SICI:
8755-6863(200110)32:4<293:BDRAIW>2.0.ZU;2-S
Fonte:
ISI
Lingua:
ENG
Soggetto:
ALTERNATE-DAY PREDNISONE; LUNG-DISEASE; INHALED CORTICOSTEROIDS; BRONCHOALVEOLAR LAVAGE; FLUTICASONE PROPIONATE; CONTROLLED TRIAL; ASTHMA; DIPROPIONATE; INFECTION; THERAPY;
Keywords:
cystic fibrosis; children; inhaled corticosteroids; neutrophil; macrophage; bronchoalveolar lavage; airway inflammation;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
40
Recensione:
Indirizzi per estratti:
Indirizzo: Accurso, FJ Childrens Hosp, Pulm Sect, 1056 E 19th Ave,Box B395, Denver, CO 80218 USA Childrens Hosp 1056 E 19th Ave,Box B395 Denver CO USA 80218 SA
Citazione:
H.A. Wojtczak et al., "Beclomethasone diproprionate reduced airway inflammation without adrenal suppression in young children with cystic fibrosis: A pilot study", PEDIAT PULM, 32(4), 2001, pp. 293-302

Abstract

Inhaled corticosteroids are commonly used in cystic fibrosis (CF), but there are few studies evaluating their safety in young children. We, therefore, prospectively administered beclomethasone diproprionate (BDP) to 12 clinically stable young children with CF to examine the safety of this therapy with respect to adrenal suppression and airway infection. To determine potential mechanisms of corticosteroid action in CF, we also examined airway markers of inflammation before and after inhaled steroid treatment. BDP 210 mug twice a day was given via spacer for 2 months. Twelve-hour serum and urine cortisols and response to low-dose synthetic ACTH cortisol stimulation were assessed. Bronchoalveolar lavage fluid (BALF) was examined pre- and posttreatment with BDP by quantitative bacteriology and indices of airway inflammation, including levels of total neutrophils, neutrophil elastase-alpha -1 antiprotease complexes (NEAP), CA 19-9 mucin-associated antigen, interleukin-8 (IL-8), and macrophage IL-8 mRNA. Following 2 months of treatment, serum and urine cortisol levels were unchanged. Response to low-dose ACTH cortisol stimulation was not significantlydecreased at 30 min. Posttreatment BALF bacteria[ density was not statistically different from pretreatment; however, one patient who was initially culture negative became culture-positive with Hemophilus influenzae. BALF total neutrophil counts, corrected for epithelial lining fluid dilution, weredecreased to approximately one third of pretreatment values (P=0.03). NEAPand CA 19-9 mucin-associated antigen demonstrated similar decreases. BALF IL-8 levels and macrophage IL-8 mRNA levels were not statistically changed. These findings suggest that treatment with BDP 420 mug per day for 2 months in young children with CF does not affect urine and blood cortisol, causes no decrease in adrenal reserve, and does not result in a clinically significant increase in airway infection. In addition, the fall in bronchoalveolar lavage fluid inflammatory markers following BDP suggests possible modulation of neutrophil influx into the CF airway and provides justification forfurther studies of inhaled corticosteroids in CF. (C) 2001 Wiley-Liss, Inc.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 29/03/20 alle ore 09:24:00