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Clinical and Translational Allergy
Published in: Clinical and Translational Allergy 1/2011

Open Access 01-12-2011 | Research

Comparing the effects of two inhaled glucocorticoids on allergen-induced bronchoconstriction and markers of systemic effects, a randomised cross-over double-blind study

Authors: Jan Lötvall, Mona Palmqvist, Peter Arvidsson

Published in: Clinical and Translational Allergy | Issue 1/2011

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Abstract

Background

Inhaled glucocorticoids are efficient in protecting against asthma exacerbations, but methods to compare their efficacy vs systemic effects have only been attempted in larger multi-centre studies. The aim of the current study was therefore to directly compare the effects of two separate inhaled glucocorticoids, mometasone and budesonide, to compare the effects on the early and late asthmatic responses to inhaled allergen in patients with mild allergic asthma, and sputum eosinophils, and to relate the clinical positive effects to any systemic effects observed.

Methods

Twelve patients with documented early and late asthmatic responses (EAR and LAR) to inhaled allergen at a screening visit were randomized in a double-blind fashion to treatment with mometasone (200 μg × 2 or 400 μg × 2), budesonide (400 μg × 2) or placebo in a double-blind crossover fashion for a period of seven days. Challenge with the total allergen dose causing both an EAR and LAR was given on the last day of treatment taken in the morning. Lung function was assessed using FEV1, and systemic glucocorticoid activity was quantified using 24 h urinary cortisol.

Results

Mometasone and budesonide attenuate both EAR and LAR to allergen to a similar degree. No significant dose-related effects on the lung function parameters were observed. Both treatments reduced the relative amount of sputum eosinophils (%) after allergen. At the dose of 800 μg daily, mometasone reduced 24 h urinary cortisol by approximately 35%. Both drugs were well tolerated.

Conclusions

Mometasone and budesonide are equieffective in reducing early and late asthmatic responses induced by inhaled allergen challenge. Mometasone 800 μg given for seven days partially affects the HPA axis.
Appendix
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Literature
1.
Boulet LP: The allergen bronchoprovocation model: an important tool for the investigation of new asthma anti-inflammatory therapies. Allergy. 2007, 62 (10): 1101-10. 10.1111/j.1398-9995.2007.01499.x.CrossRefPubMed
2.
3.
de Monchy JG, Aalbers R, Timens W: The clinical relevance of bronchial biopsies in asthma. Respir Med. 1993, 87 (Suppl B): 23-4.CrossRefPubMed
4.
5.
Gauvreau GM: The effects of inhaled budesonide on circulating eosinophil progenitors and their expression of cytokines after allergen challenge in subjects with atopic asthma. Am J Respir Crit Care Med. 2000, 162 (6): 2139-44.CrossRefPubMed
6.
Tivenius L, Kiviloog J, Glennow C: Effect of budesonide inhalation on airway obstruction at bronchial allergen provocation after varying lengths of pre-treatment. Allergy. 1984, 39 (8): 639-40. 10.1111/j.1398-9995.1984.tb01986.x.CrossRefPubMed
7.
O'Shaughnessy KM: Differential effects of fluticasone propionate on allergen-evoked bronchoconstriction and increased urinary leukotriene E4 excretion. Am Rev Respir Dis. 1993, 147 (6 Pt 1): 1472-6.CrossRefPubMed
8.
Palmqvist M: Differential effects of fluticasone and montelukast on allergen-induced asthma. Allergy. 2005, 60 (1): 65-70. 10.1111/j.1398-9995.2005.00633.x.CrossRefPubMed
9.
Inman MD: Dose-dependent effects of inhaled mometasone furoate on airway function and inflammation after allergen inhalation challenge. Am J Respir Crit Care Med. 2001, 164 (4): 569-74.CrossRefPubMed
10.
Gauvreau GM: Effect of low-dose ciclesonide on allergen-induced responses in subjects with mild allergic asthma. J Allergy Clin Immunol. 2005, 116 (2): 285-91. 10.1016/j.jaci.2005.05.021.CrossRefPubMed
11.
12.
Pizzichini MM: Spontaneous and induced sputum to measure indices of airway inflammation in asthma. Am J Respir Crit Care Med. 1996, 154 (4 Pt 1): 866-9.CrossRefPubMed
13.
Pizzichini E: Indices of airway inflammation in induced sputum: reproducibility and validity of cell and fluid-phase measurements. Am J Respir Crit Care Med. 1996, 154 (2 Pt 1): 308-17.CrossRefPubMed
14.
Pizzichini E: Measurement of inflammatory indices in induced sputum: effects of selection of sputum to minimize salivary contamination. Eur Respir J. 1996, 9 (6): 1174-80. 10.1183/09031936.96.09061174.CrossRefPubMed
15.
Inman MD: The utility of methacholine airway responsiveness measurements in evaluating anti-asthma drugs. J Allergy Clin Immunol. 1998, 101 (3): 342-8. 10.1016/S0091-6749(98)70246-5.CrossRefPubMed
16.
Inman MD: Reproducibility of allergen-induced early and late asthmatic responses. J Allergy Clin Immunol. 1995, 95 (6): 1191-5. 10.1016/S0091-6749(95)70075-7.CrossRefPubMed
17.
Gauvreau GM: Repeatability of allergen-induced airway inflammation. J Allergy Clin Immunol. 1999, 104 (1): 66-71. 10.1016/S0091-6749(99)70115-6.CrossRefPubMed
18.
Woolley KL: Effects of allergen challenge on eosinophils, eosinophil cationic protein, and granulocyte-macrophage colony-stimulating factor in mild asthma. Am J Respir Crit Care Med. 1995, 151 (6): 1915-24.CrossRefPubMed
19.
Botturi K: Differences in allergen-induced T cell activation between allergic asthma and rhinitis: Role of CD28, ICOS and CTLA-4. Respir Res. 2011, 12 (1): 25-10.1186/1465-9921-12-25.PubMedCentralCrossRefPubMed
20.
Juniper EF: Long-term effects of budesonide on airway responsiveness and clinical asthma severity in inhaled steroid-dependent asthmatics. Eur Respir J. 1990, 3 (10): 1122-7.PubMed
21.
Juniper EF: Effect of long-term treatment with an inhaled corticosteroid (budesonide) on airway hyperresponsiveness and clinical asthma in nonsteroid-dependent asthmatics. Am Rev Respir Dis. 1990, 142 (4): 832-6.CrossRefPubMed
22.
O'Byrne P: Asthma pathogenesis and allergen-induced late responses. J Allergy Clin Immunol. 1998, 102 (5): S85-9. 10.1016/S0091-6749(98)70036-3.CrossRefPubMed
23.
Parameswaran K: Protective effects of fluticasone on allergen-induced airway responses and sputum inflammatory markers. Can Respir J. 2000, 7 (4): 313-9.PubMed
Metadata
Title
Comparing the effects of two inhaled glucocorticoids on allergen-induced bronchoconstriction and markers of systemic effects, a randomised cross-over double-blind study
Authors
Jan Lötvall
Mona Palmqvist
Peter Arvidsson
Publication date
01-12-2011
Publisher
BioMed Central
Published in
Clinical and Translational Allergy / Issue 1/2011
Electronic ISSN: 2045-7022
DOI
https://doi.org/10.1186/2045-7022-1-12

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