Chest
Clinical Investigations: AsthmaInfluence of Beclomethasone and Salmeterol on the Perception of Methacholine-lnduced Bronchoconstriction
Section snippets
Subjects
Thirty subjects with mild-to-moderate asthma (12 male and 18 female), nonsmokers, aged 18 to 62 years (mean±SEM: 39.1 ±2.9 years) took part in this study. Fifteen were using only bronchodilators to control their asthma (BD group) and 15 others were using a bronchodilator associated with inhaled corticosteroids (ICS group).
Inclusion Criteria
Patients were considered eligible for this study if they had a diagnosis of allergic or nonallergic asthma in accordance with the definition of the American Thoracic Society13
Demographics and Pulmonary Function Tests
At entry into the study, the two groups of subjects were comparable for gender and PC20 (p>0.05; Table 1). Subjects in the BD group were younger than those in the ICS group (respective mean ages, 31 and 45 years; p=0.01) and showed a trend toward a shorter duration of asthma (9.5 vs 15.5 years; p>0.05). Fourteen subjects in the BD group and seven in the ICS group were atopic. At entry to the study, baseline FEV1 was higher in the BD group than in the ICS group (87.1 ±3.8% predicted and
Discussion
This study shows that salmeterol did not significantly change perception of MIB compared with placebo, either short term or after a period of 4 weeks of daily use, in asthmatic subjects either using bronchodilators alone or using them with inhaled corticosteroids. To our knowledge, only one previous study looked at the perception of induced-broncho-constriction in asthmatic patients and the effect of corticosteroid treatment, and no other study specifically compared the effects of long-acting β2
Acknowledgments
We would like to thank Lori Schubert for reviewing the manuscript.
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Symptoms and perception of airway obstruction in asthmatic patients: Clinical implications for use of reliever medications
2019, Journal of Allergy and Clinical ImmunologyCitation Excerpt :In another study, although inhalation of albuterol reduced airway obstruction and reduced Borg scale scores for dyspnea, it paradoxically increased Borg scores in response to an external resistive load.31 There is evidence that ICSs can restore or improve perception of airway obstruction,41-44,64 most likely by preventing or ameliorating airway epithelial and receptor damage caused by inflammatory cells. Boulet et al41 showed that patients using twice-daily beclomethasone dipropionate (BDP; mean daily dose, 640 ± 60 μg) plus albuterol as a reliever had a greater perception of bronchoconstriction induced by methacholine challenge than patients treated with albuterol alone in a 14-week crossover study.
The relationship between inflammation and symptoms in asthma
2008, Revue des Maladies RespiratoiresThe influence of corticosteroids on the perception of dyspnea in asthma
2007, Respiratory MedicineCitation Excerpt :In turn, this may reduce intraepithelial nerve injury or increase the production of epithelial-derived mediators being involved in the activation of airway sensory receptors.12 Because epithelial cells in particular may be a major cellular target for ICS,11 the restoration of the airway epithelial structure has been suggested as another mechanism by which corticosteroids might improve the perception of dyspnea10,12 (see Fig. 1). In addition to the intentional anti-inflammatory effects and known adverse physiologic side effects of corticosteroids, many adverse psychological effects have been reported in children and adults, including symptoms of depression, mania, psychosis and behavioral and cognitive deficits.14–16
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2006, ChestCitation Excerpt :It was reported in < 30% of subjects even at maximum response and appears to be distinct from the other clusters. Chronicity and reversibility of airway obstruction and prior use of ICS are several factors reported to affect symptom perception in asthma.38,39,40 In this study, we found no difference in dyspnea intensity or quality throughout MCT between mild and severe asthma or between individuals who were and were not receiving ICS.
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Supported by Glaxo Wellcome Canada, Bureau d'affaires du Québec and the Fonds de la Recherche en Santé du Québec (FRSQ-Industry program).