Effects of High-Dose Inhaled Fluticasone Propionate via Spacer on Cell-Mediated Immunity in Healthy Volunteers

Sharma, Kailash Chander; Stevens, Damien; Casey, Larry C.; Kesten, Steven

doi:10.1378/chest.118.4.1042

Cited by 18 publications

(14 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A 22‐month period inhaled beclomethasone in asthmatic children did not alter lymphocyte subpopulation distributions 37 nor did several weeks of treatment with fluticasone in healthy dogs, 41 or flunisolide in healthy and asthmatic cats 42 . Contrary to the effects observed after administration of a single dose 43,44 and our results, inhaled fluticasone administered for 4 weeks to healthy volunteers caused a decrease in activated CD4+ and CD8+ T cells 22 . Duration of treatment, relatively higher dosage in the study in humans, and health status of the subjects could explain these differences.…”

Section: Discussioncontrasting

confidence: 79%

“…Because of the adverse effects that have been observed with the oral or injectable use of corticosteroids, treatment duration is usually short, from days to weeks. Although better tolerated than when systemically administered in human patients, inhaled corticosteroids have nevertheless been associated with adverse effects, including a decrease in the immune response 22 and increased susceptibility to infection when administered over extended periods 35 . The risk of infection was increased especially in elderly patients and in those with severe airway obstruction, 2 key features of heaves in horses.…”

Section: Discussionmentioning

confidence: 99%

“…This approach aims at achieving maximal concentrations of drug within the airways, while minimizing systemic adverse effects. In people, in whom inhaled corticosteroids are the first‐line therapy for treatment of asthma and chronic obstructive pulmonary disease (COPD), prolonged administration of corticosteroids has been associated with adverse effects including reduction in bone density, cataracts, glaucoma, skin bruising, 21 and modulation of cellular immunity at high doses 22 . They also have been shown to induce a dose‐dependent suppression of endogenous cortisol in horses 2,23–25 suggesting that systemic effects may occur in this species.…”

mentioning

confidence: 99%

See 2 more Smart Citations

Effect of Long‐Term Fluticasone Treatment on Immune Function in Horses with Heaves

Dauvillier

Felippe

Lunn

et al. 2011

Veterinary Internal Medicne

View full text Add to dashboard Cite

Background: Corticosteroids currently are the most effective pharmacological treatment available to control heaves in horses. Systemically administered corticosteroids have been shown to alter immune response in horses, humans, and other species. Aerosolized administration theoretically minimizes systemic adverse effects, but the effect of inhaled corticosteroids on immune function has not been evaluated in horses.Objectives: To evaluate the effects of prolonged administration of inhaled fluticasone on the immune system of heavesaffected horses.Animals: Heaves-affected horses were treated with inhaled fluticasone (n 5 5) for 11 months or received environmental modifications only (n 5 5).Methods: Prospective analysis. Clinical parameters and CBC, lymphocyte subpopulations and function, and circulating neutrophil gene expression were sequentially measured. Primary and anamnestic immune responses also were evaluated by measuring antigen-specific antibodies in response to vaccination with bovine viral antigen and tetanus toxoid, respectively.Results: No clinical adverse effects were observed and no differences in immune function were detected between treated and untreated horses.Conclusions and Clinical Importance: The treatment of heaves-affected horses with inhaled fluticasone at therapeutic dosages for 11 months has no significant detectable effect on innate and adaptive (both humoral and cell-mediated) immune parameters studied. These results suggest that prolonged administration of fluticasone would not compromise the systemic immune response to pathogens nor vaccination in adult horses.

show abstract

Section: Discussioncontrasting

confidence: 79%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

See 1 more Smart Citation

Effect of Long‐Term Fluticasone Treatment on Immune Function in Horses with Heaves

Dauvillier

Felippe

Lunn

et al. 2011

Veterinary Internal Medicne

View full text Add to dashboard Cite

show abstract

“…We also found that stimulated CD4 + T cells isolated from the peripheral blood of asthmatics had significantly increased cytokine production 12 months after surgery. Participants were using less inhaled anti-inflammatory medication at 12 months, but even high dose inhaled corticosteroids do not affect response of T cells to stimulation 38 . Changes in other medications may be affecting T cell responses, this will require further investigation.…”

Section: Discussionmentioning

confidence: 99%

Effects of obesity and bariatric surgery on airway hyperresponsiveness, asthma control, and inflammation

Dixon

Pratley

Forgione

et al. 2011

Journal of Allergy and Clinical Immunology

369

295

View full text Add to dashboard Cite

Background Asthma in obese individuals is poorly understood, these patients are often refractory to standard therapy. Objectives To gain insights into the pathogenesis and treatment of asthma in obese individuals by determining how obesity and bariatric surgery affect asthma control, airway hyperresponsiveness and markers of asthmatic inflammation. Methods A prospective study of (i) asthmatic and non-asthmatic bariatric surgery patients compared at baseline, and (ii) asthmatic patients followed for 12 months after bariatric surgery. Results We studied 23 asthmatic and 21 non-asthmatic patients undergoing bariatric surgery. At baseline, asthmatics had lower FEV1 and FVC, and lower levels of lymphocytes in bronchoalveolar lavage. Following surgery, asthmatic participants experienced significant improvements in asthma control (asthma control score 1.55 to 0.74, p < 0.0001) and asthma quality of life (4.87 to 5.87, p < 0.0001). Airways responsiveness to methacholine improved significantly (PC20 3.9 to 7.28, p = 0.03). There was a statistically significant interaction between IgE status and change in airways responsiveness (p for interaction term = 0.01), improvement in AHR was significantly related to change in BMI in those with normal IgE (p = 0.02, R2 = 0.46). The proportion of lymphocytes in bronchoalveolar lavage and production of cytokines from activated peripheral blood CD4+ T cells increased significantly. Conclusions Bariatric surgery improves airway hyperresponsiveness in obese asthmatics with normal serum IgE. Weight loss has dichotomous effects on airway physiology and T cell function typically involved in the pathogenesis of asthma, suggesting that obesity produces a unique phenotype of asthma that will require a distinct therapeutic approach.

show abstract

“…One hypothesis to explain the above results is the observation of commorbidities associated with narcolepsy, such as a significant incidence of depression 17 . It is known that depression is associated with higher plasma level of corticotrophines with an alteration of the cell immunological system 18 . Unfortunately, given that our patients were not systematically evaluated for depression, we are unable to verify, first-hand, this hypothesis.…”

Section: Discussionmentioning

confidence: 99%

A study of T CD4, CD8 and B lymphocytes in narcoleptic patients

Coelho

Pradella-Hallinan

Alves

et al. 2007

Arq. Neuro-Psiquiatr.

View full text Add to dashboard Cite

Narcolepsy is characterized by excessive daytime sleep and cataplexy. Sleep paralysis and hypnagogic hallucinations can be added to this clinical picture 1,2 . Narcolepsy involves an unknown physiopathology but with a known association with the HLA DQB1*06023 allele 3 . This would fortify the hypothe- ABSTRACT -Narcolepsy is characterized by excessive daytime sleep and cataplexy. Little is known about the possible difference in pathophysiology between patients with or without cataplexy. Obje�tive: To quantify T CD4, T CD8 and B lymphocytes in subgroups of patients with narcolepsy and the presence or absence of the HLA-DQB1*0602 allele between groups. Method: Our study was prospective and controlled (transversal) with 22 narcoleptic patients and 23 health control subjects. Patients underwent an all-night polysomnographic recording (PSG) and a multiple sleep latency Test (MSLT). The histocompatibility antigen allele (HLA-DQB1*0602), T CD4, CD8 and B lymphocytes were quantified in control subjects and in narcoleptics. Results: The HLA-DQB1*0602 allele was identified in 10 (62.5%) of our 16 cataplexic subjects and in 2 (33.3%) of the 6 patients without cataplexy (p=0.24). In control subjects, HLA-DQB1*0602 allele was identified in 5 (20%). A significant decrease in T CD4 and B lymphocytes was found in narcoleptic patients with recurrent cataplexy when compared with our patients without cataplexy. Con�lusion: Autoimmune diseases such as systemic lupus erythematosus and rheumatoid arthritis were associated with a decrease in sub-group of T CD4 and B lymphocytes. A drop in B lymphocytes count in reumathoid arthritis might, it is posited, be correlated to the presence of HLA-DRB1 allele along with an overall worsened outcome of the affliction. The theory of an increase in consumption of B lymphocytes over the maturation phase has likewise been put forward. Our study reinforces the view that narcolepsy should be considered from an immunological perspective.Key wORDS: narcolepsy, lymphocytes, immunology, HLA-DQB1*0602 allele. estudo dos linfócitos t Cd4, Cd8 e B em pacientes com narcolepsiaReSUMO -A narcolepsia é caracterizada por sonolência excessiva diurna e cataplexia. Pouco se sabe sobre as diferenças fisiopatológicas entre pacientes com e sem cataplexia. Objetivo: Quantificar os linfócitos T CD4, T CD8 e B e a presença do alelo HLA-DQB1*0602 nos subgrupos de pacientes com narcolepsia. Mé� todo: O estudo foi prospectivo e controlado (transversal) com 22 pacientes portadores de narcolepsia e 23 sujeitos controle. Os pacientes realizaram polissonografia (PSG) de noite inteira e teste de múltiplas latên-cias do sono (TMLS). O alelo do antígeno de histocompatibilidade (HLA-DQB1*0602) e os linfócitos T CD4, T CD8 e B foram quantificados nos pacientes e sujeitos controle. Resultados: O alelo HLA-DQB1*0602 foi encontrado em 10 (62,5%) dos 16 pacientes com cataplexia e em 2 (33,3%) dos 6 pacientes sem cataplexia (p=0,24). Nos sujeitos controle, o alelo HLA-DQB1*0602 foi encontrado em 5 sujeitos (20%). Um aumento significativo...

show abstract

Effects of High-Dose Inhaled Fluticasone Propionate via Spacer on Cell-Mediated Immunity in Healthy Volunteers

Cited by 18 publications

References 26 publications

Effect of Long‐Term Fluticasone Treatment on Immune Function in Horses with Heaves

Effect of Long‐Term Fluticasone Treatment on Immune Function in Horses with Heaves

Effects of obesity and bariatric surgery on airway hyperresponsiveness, asthma control, and inflammation

A study of T CD4, CD8 and B lymphocytes in narcoleptic patients

Contact Info

Product

Resources

About