Vagaggini Barbara, Cianchetti Silvana, Bartoli Marialaura, Ricci Manrico, Bacci Elena, Dente Federico L, Di Franco Antonella, Paggiaro Pierluigi
Pneumology Section, Cardiothoracic Department, University of Pisa, Pisa, Italy.
Respiration. 2007;74(1):61-8. doi: 10.1159/000096078. Epub 2006 Oct 4.
The effect of corticosteroids on the ozone (O3)-induced airway inflammation is still debated.
The aim of the study was to confirm the effect of a short-term treatment with oral glucocorticosteroids on O3-induced airway inflammation, detected by induced sputum analysis, and on functional response in glucocorticosteroid-naive subjects.
A randomized, placebo-controlled study using oral prednisone (25 mg o.d. for 4 days) was carried out. Nine mild persistent asthmatics were exposed for 2 h, on separatedays, to 0.27 ppm O3 and to air in random order, after 4 days of treatment with prednisone (25 mg o.d.) and after 4 days of placebo.Before and after exposure, pulmonary function test was measured; 6 h afterexposure, sputum induction was done.
Oral glucorticosteroids did not prevent pulmonary function decrement due to O3. After placebo, the percentage of neutrophils in induced sputum was significantly higher after O3 than after air [52.1 (15.7-77.3) vs. 17.8 (1.7-58.4), p=0.02, O3 vs. air]. This difference was lost after 4 days of treatment with prednisone [35.2% (10-96.2) vs. 30.9% (6.1-75.6), n.s., O3 vs. air]. Neutrophil elastase in sputum supernatant increased after O3 exposure in the sample obtained after placebo, but not after prednisone treatment.
This study confirms that glucocorticosteroids reduce inflammatory airway response, but do not prevent the airway functional impairment after O3 exposure.
皮质类固醇对臭氧（O3）诱导的气道炎症的影响仍存在争议。
本研究旨在证实口服糖皮质激素短期治疗对O3诱导的气道炎症（通过诱导痰分析检测）以及对未使用过糖皮质激素的受试者功能反应的影响。
进行了一项使用口服泼尼松（每日25mg，共4天）的随机、安慰剂对照研究。9名轻度持续性哮喘患者在接受泼尼松（每日25mg）治疗4天后和接受安慰剂治疗4天后，于不同日期分别暴露于0.27ppm O3和空气中2小时。暴露前后测量肺功能；暴露6小时后进行痰液诱导。
口服糖皮质激素不能预防O3导致的肺功能下降。服用安慰剂后，O3暴露后诱导痰中中性粒细胞百分比显著高于空气暴露后[52.1（15.7 - 77.3）对17.8（1.7 - 58.4），p = 0.02，O3对空气]。泼尼松治疗4天后这种差异消失[35.2%（10 - 96.2）对30.9%（6.1 - 75.6），无统计学意义，O3对空气]。安慰剂组样本中O3暴露后痰上清液中的中性粒细胞弹性蛋白酶增加，但泼尼松治疗后未增加。
本研究证实糖皮质激素可减轻气道炎症反应，但不能预防O3暴露后的气道功能损害。
