Continuous Isoproterenol Inhalation Therapy in Children with Severe Asthmatic Attack

Iíkura, Yoji; Matsumoto, Tsutomu; Fujita, Kazuhisa; Otsuka, Tadashi; Sakamoto, Yasutoshi; Yun, Sun; Saito, Hirohisa; Obata, Toshihiko; Akasawa, Akira; Capulong, Maria Chona T.; Sakaguchi, Naoya; Oya, Yasushi; Tahara, Koichiro; Tachimoto, Hiroshi; Kawahara, Hidetoshi; Koya, N

doi:10.1159/000237606

Cited by 16 publications

(13 citation statements)

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“…Conversely, strong and full agonists such as PC and isoproterenol may be appropriate as reliever medications with sedative effects on inflammatory granulocyte (neutrophils and eosinophils) in acute severe asthma. Actually, the clinical use of isoproterenol (full agonist) inhalation therapy has the most significant effect for patients with severe asthma attacks [35], and the airway responsiveness is known to subside under the treatment of PC [36]. …”

Section: Discussionmentioning

confidence: 99%

Differential Effects of Short-Acting β<sub>2</sub>-Agonists on Human Granulocyte Functions

Yasui¹,

Kobayashi²,

Yamazaki³

et al. 2005

Int Arch Allergy Immunol

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Background: β₂-Adrenergic agonists play a pivotal role in the management of bronchial asthma. Although the major effect of short-acting β₂-agonists on the airway is relaxation of smooth muscles, they may also have several effects on surrounding immunomodulatory cells. Methods: We examined whether widely used short-acting β₂-agonists differ in their ability to modulate granulocyte functions, such as superoxide anion (O₂^–) production and degranulation. Results: Procaterol (PC), a full agonist, significantly inhibited both O₂^– production by granulocytes (neutrophils and eosinophils) and their degranulation at the clinically relevant concentrations, whereas salbutamol and tulobuterol (partial agonists) showed smaller effects. PC inhibited N-formyl methionyl-leucyl-phenylalanine-induced O₂^– production and peroxidase release, but failed to inhibit responses induced by phorbol 12-myristate 13-acetate and/or opsonized zymosan. Exposure to 5 × 10^–8M PC for 120 min resulted in approximately 50% inhibition of O₂^– production and degranulation of neutrophils. The effects of β₂-agonists were more obvious in neutrophils than in eosinophils. A selective β₂-receptor antagonist, ICI-118551, reversed the inhibitory effect of β₂-agonists (PC, salbutamol, tulobuterol B) on N-formyl methionyl-leucyl-phenylalanine-induced O₂^– production. Conclusions: These results suggest that β₂-agonists had an inhibitory effect on granulocyte functions, mainly mediated viareceptors and their efficacy. Our observations support that β₂-agonists with a rapid onset of action and high intrinsic efficacy (short-acting and full agonists) may be optimal for the rescue therapy against acute asthma attack and sedation of its airway inflammation in an early phase.

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Section: Discussionmentioning

confidence: 99%

Differential Effects of Short-Acting β<sub>2</sub>-Agonists on Human Granulocyte Functions

Yasui¹,

Kobayashi²,

Yamazaki³

et al. 2005

Int Arch Allergy Immunol

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“…Asthpul) inhalation. [17][18][19] During this treatment, monitor blood pressure, heart rate, respiratory rate, SpO2, etc. The continuous inhalation is usually very effective, whose effects can be noted within 30 min.…”

Section: Treatment and Procedures In Wardsmentioning

confidence: 99%

Japanese Guideline for Childhood Asthma 2014

Hamasaki

Kohno

Ebisawa

et al. 2014

Allergology International

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The Japanese Guideline for the Diagnosis and Treatment of Allergic Diseases 2013 (JAGL 2013) describes childhood asthma after the Japanese Pediatric Guideline for the Treatment and Management of Asthma 2012 (JPGL 2012) by the Japanese Society of Pediatric Allergy and Clinical Immunology. JAGL 2013 provides information on diagnosis by age group from infancy to puberty (0-15 years of age), treatment for acute exacerbations, long-term management by anti-inflammatory drugs, daily life guidance, and patient education to allow non-specialist physicians to refer to this guideline for routine medical treatment. JAGL differs from the Global Initiative for Asthma Guideline (GINA) in that JAGL emphasizes early diagnosis and intervention at <2 years and 2-5 years of age. A management method, including step-up or step-down of long-term management drugs based on the status of asthma control levels, as in JAGL, is easy to understand, and thus the Guideline is suitable as a frame of reference for routine medical treatment. JAGL has also introduced treatment and management using a control test on children, recommending that the physician aim at complete control by avoiding exacerbation factors and by appropriate use of anti-inflammatory drugs.

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“…[17][18][19] During this treatment, monitor blood pressure, heart rate, respiratory rate, SpO2, etc. [17][18][19] During this treatment, monitor blood pressure, heart rate, respiratory rate, SpO2, etc.…”

Section: Additional Treatmentmentioning

confidence: 99%

Japanese Guideline for Childhood Asthma

Nishimuta

Kondo

Hamasaki

et al. 2011

Allergology International

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The Japanese Guideline for the Diagnosis and Treatment of Allergic Diseases 2010 (JAGL 2010) describes childhood asthma based on the Japanese Pediatric Guideline for the Treatment and Management of Asthma 2008 (JPGL 2008) published by the Japanese Society of Pediatric Allergy and Clinical Immunology. JAGL 2010 provides information on diagnosis by age groups from infancy to puberty, treatment for acute exacerbations, long-term management by medication, daily life guidance, and patient education to allow physicians, not specialized in childhood asthma, to refer to this guideline for routine medical treatment. JAGL differs from the Global Initiative for Asthma Guideline (GINA) in that the former emphasizes long-term management of childhood asthma based on asthma severity and early diagnosis and intervention at <2 years and 2-5 years of age. However, a management method, including step-up or step-down of long-term management agents based on the status of asthma symptoms, is easy to understand and thus JAGL is suitable for routine medical treatment. JAGL also introduced treatment and management using a control test for children, recommending treatment and management aimed at complete control through avoiding exacerbation factors and appropriate use of antiinflammatory agents.

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Continuous Isoproterenol Inhalation Therapy in Children with Severe Asthmatic Attack

Cited by 16 publications

References 0 publications

Differential Effects of Short-Acting β<sub>2</sub>-Agonists on Human Granulocyte Functions

Differential Effects of Short-Acting β<sub>2</sub>-Agonists on Human Granulocyte Functions

Japanese Guideline for Childhood Asthma 2014

Japanese Guideline for Childhood Asthma

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