Singam Rajeswari, Jena Prasanna K, Behera Sumita, Hellermann Gary R, Lockey Richard F, Ledford Dennis, Mohapatra Shyam S
Division of Allergy and Immunology, Joy McCann Culverhouse Airway Disease Research Center, University of South Florida College of Medicine and James A, Haley VA Hospital, Tampa, FL, USA.
Virol J. 2006 May 23;3:32. doi: 10.1186/1743-422X-3-32.
Respiratory syncytial virus (RSV) infection is the major cause of bronchiolitis in infants and is a risk factor for the development of asthma. Allergic asthmatics are more susceptible to RSV infection and viral exacerbation.
Since the effectiveness of corticosteroids in treating RSV infection has been controversial, we tested fluticasone propionate (FP) and salmeterol (Sal) alone versus FP plus Sal (FPS) on RSV-induced airway inflammation. Mice were sensitized and challenged with ovalbumin (OVA) and infected with RSV. Following infection they were treated with FP, Sal, or FPS intranasally and airway hyperreactivity (AHR), inflammation and RSV titers were examined.
The group treated with FPS showed significantly lower AHR compared to the group treated with FP or Sal alone. The group treated with FP alone showed slightly decreased (non-significant) AHR compared to controls. Treatment with FPS resulted in significant decreases in the percentage of eosinophils and neutrophils in bronchoalveolar lavage fluid and in lung pathology compared to FP or Sal. FP alone decreased eosinophils but not neutrophils or lymphocytes, while Sal alone decreased eosinophils and neutrophils but not lymphocytes. FPS treatment of mice infected with RSV in the absence of allergen sensitization resulted in a 50% decrease of RSV titer in the lung and a reduction in neutrophils compared to FP or Sal.
Together, these results indicate that fluticasone in combination with salmeterol is a more effective treatment for decreasing airway hyperreactivity and inflammation than either of them alone in allergen-sensitized, RSV-infected mice.
呼吸道合胞病毒（RSV）感染是婴儿细支气管炎的主要病因，也是哮喘发生的一个危险因素。过敏性哮喘患者更容易感染RSV并出现病毒感染加重的情况。
由于皮质类固醇治疗RSV感染的有效性一直存在争议，我们测试了丙酸氟替卡松（FP）和沙美特罗（Sal）单独使用以及FP联合Sal（FPS）对RSV诱导的气道炎症的作用。用卵清蛋白（OVA）对小鼠进行致敏和激发，并感染RSV。感染后，通过鼻腔给予FP、Sal或FPS进行治疗，并检测气道高反应性（AHR）、炎症和RSV滴度。
与单独使用FP或Sal治疗的组相比，接受FPS治疗的组AHR显著降低。与对照组相比，单独使用FP治疗的组AHR略有下降（无统计学意义）。与FP或Sal相比，FPS治疗可使支气管肺泡灌洗液中的嗜酸性粒细胞和中性粒细胞百分比以及肺部病理情况显著降低。单独使用FP可降低嗜酸性粒细胞，但对中性粒细胞或淋巴细胞无影响，而单独使用Sal可降低嗜酸性粒细胞和中性粒细胞，但对淋巴细胞无影响。在未进行过敏原致敏的情况下，对感染RSV的小鼠进行FPS治疗，与FP或Sal相比，可使肺部RSV滴度降低50%，并减少中性粒细胞。
总之，这些结果表明，在过敏原致敏、RSV感染的小鼠中，氟替卡松与沙美特罗联合使用比单独使用其中任何一种药物在降低气道高反应性和炎症方面更有效。
