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Budesonide reduces sensitivity and reactivity to inhaled mannitol in asthmatic subjects
Author(s) -
BRANNAN JOHN D.,
KOSKELA HEIKKI,
ANDERSON SANDRA D.,
CHAN H. KIM
Publication year - 2002
Publication title -
respirology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.857
H-Index - 85
eISSN - 1440-1843
pISSN - 1323-7799
DOI - 10.1046/j.1440-1843.2002.00357.x
Subject(s) - medicine , budesonide , mannitol , airway , asthma , anesthesia , inhalation , corticosteroid , pulmonary function testing , lung function , airway resistance , gastroenterology , lung , chemistry , organic chemistry
Objective: The aim of the study was to investigate whether treatment using inhaled corticosteroids decreases airway responsiveness to inhaled mannitol in asthmatic subjects. Methodology: Before treatment or a change in treatment with inhaled corticosteroids, 18 asthmatic subjects had measurements of lung function and airway sensitivity to mannitol taken and they completed a self‐administered questionnaire on asthma symptoms. The procedure was repeated 6–9 weeks after taking 800–2400 μg/day of budesonide. Results: There were significant reductions in airway sensitivity (provoking dose to induce a 15% fall in FEV 1 (PD 15 )) and airway reactivity measured by the response dose ratio (RDR; final percentage fall FEV 1 /total dose of mannitol administered). The PD 15 (Gmean (95%CI)) increased from 78 mg (51, 117) before treatment to 289 mg (202, 414) following treatment ( P < 0.001). All subjects had a significant increase beyond the repeatability of 0.9 doubling doses with seven subjects becoming unresponsive. There was a 4.2 (3.4, 4.9)‐fold improvement in the RDR with the value before the treatment period 0.18 (0.12, 0.28) decreasing to 0.04 (0.03, 0.08) following treatment ( P < 0.001). These improvements were associated with significant improvements in lung function and symptom severity. Conclusion: Treatment with the inhaled corticosteroid budesonide caused a decrease in airway sensitivity and reactivity to inhaled mannitol and this was associated with expected improvements in lung function and symptoms.