Inhaled corticosteroids and the beneficial effect of deep inspiration in asthma

Nicola Scichilone, Solbert Permutt, Vincenzo Bellia, Alkis Togias

Research output: Contribution to journalArticle

Abstract

Deep inspiration-induced bronchoprotection and bronchodilation are impaired in asthma. We evaluated the effect of inhaled glucocorticosteroids on these phenomena. Two groups of subjects with asthma, 9 with moderate/severe hyperresponsiveness to methacholine, and 12 with mild/borderline hyperresponsiveness to methacholine, received inhaled fluticasone (880 μg daily) for 12 weeks. Serial bronchoprovocations were performed at Weeks 0, 6, and 12. The impact of deep inspirations on the airway response to methacholine was evaluated on the basis of inspiratory vital capacity and FEV1. Fluticasone produced a wide spectrum of changes in the beneficial effects of deep inspiration, but the mean changes were not significant. The magnitude of the steroid-induced changes in bronchoprotection by deep inspiration correlated with baseline log PC20 (the provocative concentration of methacholine causing a 20% fall in FEV1; higher log PC20 predicted improvement of the deep inspiration effect). The steroid-induced changes led to the emergence of strong positive correlations between the effects of deep inspiration and the methacholine log PC20 that did not exist at baseline. We conclude that deep inspiration-induced bronchoprotection can be restored by inhaled glucocorticosteroids only in individuals with mild hyperresponsiveness. After steroid treatment, the beneficial effects of deep inspiration become significant determinants of the magnitude of airway hyperresponsiveness.

Original languageEnglish (US)
Pages (from-to)693-699
Number of pages7
JournalAmerican journal of respiratory and critical care medicine
Volume172
Issue number6
DOIs
StatePublished - Sep 15 2005

Keywords

  • Airway hyperresponsiveness
  • Asthma
  • Deep inspiration
  • Fluticasone
  • Methacholine

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine

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