Lee C, Klaustermeyer W B
Department of Medicine, Division of Allergy and Immunology, VA Greater Los Angeles Healthcare System/University of California Los Angeles, Los Angeles, CA, United States.
Allergol Immunopathol (Madr). 2012 Mar-Apr;40(2):100-3. doi: 10.1016/j.aller.2011.11.001. Epub 2012 Jan 10.
Cell mediated immunity is suppressed by systemic corticosteroids. Inhaled corticosteroids have been shown to affect parameters including bone metabolism, hypothalamus-pituitary adrenal axis, linear growth, and lead to the development of cataracts. However, it is unclear if high dose inhaled corticosteroid therapy affects cell mediated immunity.
To evaluate if asthma patients taking high dose inhaled corticosteroids chronically have reduced cell mediated immunity compared to asthma patients not taking inhaled corticosteroids.
Eighteen asthmatic subjects participated in this cross-sectional study. Cell mediated immunity was evaluated in nine patients who had been taking high dose inhaled corticosteroids for >6 months and nine patients not taking inhaled corticosteroids. Cell mediated immunity was evaluated by delayed type hypersensitivity (DTH) skin testing with intradermal placement of candida and tetanus antigens.
There was no significant difference in DTH skin test results between the high dose inhaled corticosteroid and no corticosteroid treated asthma group.
Patients with asthma taking high dose inhaled corticosteroids chronically (>6 months) did not have significantly greater impaired cell mediated immunity than patients not taking inhaled corticosteroids in this study.
全身用皮质类固醇会抑制细胞介导的免疫。吸入性皮质类固醇已被证明会影响包括骨代谢、下丘脑 - 垂体 - 肾上腺轴、线性生长等参数，并导致白内障的发生。然而，高剂量吸入性皮质类固醇疗法是否会影响细胞介导的免疫尚不清楚。
评估长期服用高剂量吸入性皮质类固醇的哮喘患者与未服用吸入性皮质类固醇的哮喘患者相比，其细胞介导的免疫是否降低。
18名哮喘受试者参与了这项横断面研究。对9名服用高剂量吸入性皮质类固醇超过6个月的患者和9名未服用吸入性皮质类固醇的患者进行细胞介导免疫评估。通过皮内注射白色念珠菌和破伤风抗原进行迟发型超敏反应（DTH）皮肤试验来评估细胞介导免疫。
高剂量吸入性皮质类固醇治疗组和未用皮质类固醇治疗的哮喘组之间的DTH皮肤试验结果无显著差异。
在本研究中，长期（超过6个月）服用高剂量吸入性皮质类固醇的哮喘患者，其细胞介导免疫受损程度并不比未服用吸入性皮质类固醇的患者明显更严重。
