Cardio-Thoracic and Vascular Department, University of Pisa, Pisa, Italy.
Eur J Clin Invest. 2010 Jun;40(6):566-9. doi: 10.1111/j.1365-2362.2010.02297.x. Epub 2010 Apr 28.
The inhibitory effect of corticosteroids (CS) on the secretions of cysteinyl-leukotrienes (Cys-LTs) in asthma is controversial. The aim of this study was to evaluate the effect of CS on allergen-induced increase in urinary leukotriene E4 (uLTE4) during early (EAR) and late (LAR) asthmatic responses in mild untreated asthmatics.
Nine subjects with mild untreated allergic asthma performed two allergen challenges, after 1-week treatment with beclomethasone dipropionate (BDP, 500 microg b.i.d) or placebo. Forced Expiratory Volume in one second 1 (FEV1) was monitored to assess EAR and LAR, and uLTE4 was measured before and during EAR and LAR.
After placebo, uLTE4 increased significantly during EAR, but not during and after LAR, in comparison with baseline values. Beclomethasone dipropionate induced a significant attenuation of the uLTE4 increase during EAR, in comparison with placebo, in association with a good protection of LAR (P = 0.002) and a mild protection of EAR (P = 0.07).
Beclomethasone dipropionate blunts the early increase in uLTE4 excretion due to allergen challenge, in association with a significant effect on the severity of LAR. These data support the hypothesis that inhaled CS may inhibit the allergen-induced release of cys-LTs in asthma.
皮质类固醇（CS）对哮喘中半胱氨酰白三烯（Cys-LTs）分泌的抑制作用存在争议。本研究旨在评估 CS 对轻度未治疗哮喘患者变应原诱发尿白三烯 E4（uLTE4）在早期（EAR）和晚期（LAR）哮喘反应中的增加的影响。
9 名轻度未治疗的过敏性哮喘患者在接受丙酸倍氯米松（BDP，500μg b.i.d）或安慰剂治疗 1 周后进行了两次变应原激发。用力呼气量 1（FEV1）用于评估 EAR 和 LAR，并在 EAR 和 LAR 之前和期间测量 uLTE4。
与基线值相比，安慰剂后 EAR 期间 uLTE4 显著增加，但 LAR 期间和之后没有增加。与安慰剂相比，BDP 显著抑制了 EAR 期间 uLTE4 的增加，与 LAR 的良好保护（P = 0.002）和 EAR 的轻度保护（P = 0.07）相关。
BDP 抑制了因变应原激发而导致的 uLTE4 排泄的早期增加，与 LAR 严重程度的显著影响相关。这些数据支持了这样的假设，即吸入性 CS 可能抑制哮喘中变应原诱导的 Cys-LTs 释放。
