Department of Respiratory Medicine, West China Hospital, Sichuan University, Chengdu 610041, China.
Acta Pharmacol Sin. 2011 Jan;32(1):126-32. doi: 10.1038/aps.2010.170. Epub 2010 Dec 20.
To evaluate the effect of inhaled formoterol-budesonide on airway remodeling in adult patients with moderate asthma.
Thirty asthmatic patients and thirty control subjects were enrolled. Asthmatic subjects used inhaled Symbicort 4.5/160 μg twice daily for one year. The effect of formoterol-budesonide on airway remodeling was assessed with comparing high-resolution computer tomography (HRCT) images of asthmatic patients and controls, as well as expression levels of cytokines and growth factors, inflammatory cell count in induced sputum, and airway hyper-responsiveness.
The differences in age and gender between the two groups were not significant. However, differences in FVC %pred, FEV(1) %pred, and PC(20) between the two groups were significant. After treatment with formoterol-budesonide, the asthma patients' symptoms were relieved, and their lung function was improved. The WT and WA% of HRCT images in patients with asthma was increased, whereas treatment with formoterol-budesonide caused these values to decrease. The expression of MMP-9, TIMP-1, and TGF-β(1) in induced sputum samples increased in patients with asthma and decreased dramatically after treatment with formoterol-budesonide. The WT and WA% are correlated with the expression levels of cytokines and growth factors, inflammatory cell count in induced sputum, and airway hyper-responsiveness, while these same values are correlated negatively with FEV(1)/FVC and FEV(1)%.
Formoterol-budesonide might interfere in chronic inflammation and airway remodeling in asthmatic patients. HRCT can be used to effectively evaluate airway remodeling in asthmatic patients.
评估吸入福莫特罗-布地奈德对成人中重度哮喘患者气道重塑的影响。
纳入 30 例哮喘患者和 30 例对照者。哮喘患者使用布地奈德福莫特罗粉吸入剂(Symbicort)4.5/160μg,每日 2 次,治疗 1 年。通过比较哮喘患者和对照者的高分辨率计算机断层扫描(HRCT)图像,以及细胞因子和生长因子的表达水平、诱导痰中炎症细胞计数和气道高反应性,评估福莫特罗-布地奈德对气道重塑的影响。
两组间年龄和性别差异无统计学意义。然而,两组间 FVC%预计值、FEV1%预计值和 PC20 值差异有统计学意义。福莫特罗-布地奈德治疗后,哮喘患者的症状得到缓解,肺功能得到改善。哮喘患者 HRCT 图像的 WT 和 WA%增加,而福莫特罗-布地奈德治疗后这些值降低。诱导痰中 MMP-9、TIMP-1 和 TGF-β1 的表达在哮喘患者中增加,福莫特罗-布地奈德治疗后显著降低。WT 和 WA%与细胞因子和生长因子的表达水平、诱导痰中炎症细胞计数和气道高反应性相关,而与 FEV1/FVC 和 FEV1%呈负相关。
福莫特罗-布地奈德可能干预哮喘患者的慢性炎症和气道重塑。HRCT 可有效评估哮喘患者的气道重塑。