Juergens U R, Dethlefsen U, Steinkamp G, Gillissen A, Repges R, Vetter H
Department of Pneumology, Medical Outpatient Clinic, Bonn University Hospital, Germany.
Respir Med. 2003 Mar;97(3):250-6. doi: 10.1053/rmed.2003.1432.
Airway hypersecretion is mediated by increased release of inflammatory mediators and can be improved by inhibition of mediator production. We have recently reported that 1.8-cineol (eucalyptol) which is known as the major monoterpene of eucalyptus oil suppressed arachidonic acid metabolism and cytokine production in human monocytes. Therefore, the aim of this study was to evaluate the anti-inflammatory efficacy of 1.8-cineol by determining its prednisolone equivalent potency in patients with severe asthma. Thirty-two patients with steroid-dependent bronchial asthma were enrolled in a double-blind, placebo-controlled trial. After determining the effective oral steroid dosage during a 2 month run-in phase, subjects were randomly allocated to receive either 200 mg 1.8-cineol t. i.d. or placebo in small gut soluble capsules for 12 weeks. Oral glucocorticosteroids were reduced by 2.5 mg increments every 3 weeks. The primary end point of this investigation was to establish the oral glucocorticosteroid-sparing capacity of 1.8-cineol in severe asthma. Reductions in daily prednisolone dosage of 36% with active treatment (range 2.5-10 mg, mean: 3.75 mg) vs. a decrease of only 7% (2.5-5 mg, mean: 0.91 mg) in the placebo group (P = 0.006) were tolerated. Twelve of 16 cineol vs. four out of 16 placebo patients achieved a reduction of oral steroids (P = 0.012). Long-term systemic therapy with 1.8-cineol has asignificant steroid-saving effect in steroid-depending asthma. This is the first evidence suggesting an anti-inflammatory activity of the monoterpene 1.8-cineol in asthma and a new rational for its use as mucolytic agent in upper and lower airway diseases.
气道高分泌由炎症介质释放增加介导，抑制介质产生可改善该症状。我们最近报道，作为桉叶油主要单萜成分的1,8-桉叶素（桉叶醇）可抑制人单核细胞中花生四烯酸代谢和细胞因子产生。因此，本研究旨在通过测定1,8-桉叶素在重度哮喘患者中的泼尼松龙等效效力，评估其抗炎效果。32例依赖类固醇的支气管哮喘患者参与了一项双盲、安慰剂对照试验。在为期2个月的导入期确定有效的口服类固醇剂量后，受试者被随机分配接受200mg 1,8-桉叶素，每日3次，或接受小肠可溶性胶囊中的安慰剂，为期12周。每3周将口服糖皮质激素剂量减少2.5mg。本研究的主要终点是确定1,8-桉叶素在重度哮喘中节省口服糖皮质激素的能力。活性治疗组泼尼松龙日剂量降低36%（范围2.5 - 10mg，平均：3.75mg），而安慰剂组仅降低7%（2.5 - 5mg，平均：0.91mg）（P = 0.006）。16例服用桉叶素的患者中有12例、16例服用安慰剂的患者中有4例实现了口服类固醇减量（P = 0.012）。1,8-桉叶素长期全身治疗对依赖类固醇的哮喘有显著的类固醇节省作用。这是首个表明单萜1,8-桉叶素在哮喘中具有抗炎活性的证据，也为其在上、下气道疾病中用作黏液溶解剂提供了新的理论依据。
