The increased expression of VEGF and VEGFR(1) in asthmatic patients is accompanied by an increased number and size of blood vessels in asthmatic airways, as well as airway remodelling. Budesonide/formoterol therapy for 6 months can decrease the expression of VEGF and VEGFR(1) alongside airway remodelling in asthma. The inhibition of VEGF and its receptor may be a good therapeutic strategy for asthma.

Aim: To evaluate the effect of inhaled formoterol-budesonide on airway remodeling in adult patients with moderate asthma. Methods: 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. Results: 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 %. Conclusion: 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.

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