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Allergy Asthma Immunol Res. 2014 Mar;6(2):175-178. English.
Published online 2013 November 05. http://dx.doi.org/10.4168/aair.2014.6.2.175 |
| Copyright © 2014 The Korean Academy of Asthma, Allergy and Clinical Immunology • The Korean Academy of Pediatric Allergy and Respiratory Disease |
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Byung-Jae Lee,1 Yun-Jin Jeung,1 Jin-Young Lee,2 Mi-Jung Oh,3 and Dong-Chull Choi 1 |
| 1Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. |
| 2Center for Health Promotion, Samsung Medical Center, Seoul, Korea. |
| 3Department of Internal Medicine, Bundang Jaeseng Hospital, Seongnam, Korea. |
Correspondence to: Dong-Chull Choi, MD, PhD, Division of Allergy, Department of Medicine, Samsung Medical Center, 81 Irwon-ro, Gangnam-gu, Seoul 135-710, Korea. Tel: +82-2-3410-3422; Fax: +82-2-3410-3849; Email: dcchoi@skku.edu
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Received August 01, 2012; Revised February 19, 2013; Accepted April 03, 2013.
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This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
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Abstract
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Purpose
Long-acting β2 agonists (LABA) may mask ongoing bronchial inflammation, leaving asthmatic patients at greater risk of severe complications. The aim of this study was to compare the effect of combination therapy using low-dose inhaled corticosteroids (ICS) plus LABA on airway inflammation in asthma to the effect of medium-dose ICS alone.
Methods
Twenty-four patients with asthma not controlled by low-dose (400 µg per day) budesonide alone were enrolled in this prospective crossover study. Patients were randomized into 2 treatment phases: one receiving medium-dose (800 µg per day) budesonide (ICS phase), and the other receiving a combination therapy of low-dose budesonide/formoterol (360 µg/9 µg per day) delivered by a single inhaler (LABA phase). Each treatment phase lasted for 6 week, after which patients were crossed over. Asthma symptoms, lung function, and airway inflammation were compared between the 2 phases.
Results
Twenty-three patients completed the study; adequate sputum samples were collected from 17 patients. Asthma symptoms and lung function remained similar between the 2 phases. However, the mean sputum eosinophil percentage was higher in the LABA phase than in the ICS phase (5.07±3.82% vs. 1.02±1.70%; P - 0.01). Sputum eosinophilia (≥3%) was more frequently observed in the LABA phase than in the ICS phase (six vs. two).
Conclusion
Addition of LABA may mask airway eosinophilic inflammation in asthmatic patients whose symptoms are not controlled with low-dose ICS.
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Keywords: Airway, inflammation, asthma, corticosteroids, beta2-agonists.
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Open Access
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