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2. Cysteinyl leukotrienes in allergic inflammation: strategic target for therapy.

Author

Busse W and Kraft M

Abstract

Systemically bioavailable leukotriene receptor antagonists (LTRAs) can reduce the essential components of allergic inflammation in allergic rhinitis (AR) and asthma by blocking cysteinyl leukotriene (CysLT) activity, resulting in a wide range of clinical effects. CysLTs, mediators, and modulators in the pathophysiology of asthma and AR are a key target for therapy because they modulate production of hemopoietic progenitor cells, survival and recruitment of eosinophils to inflamed tissue, activity of cytokines and chemokines, quantity of exhaled NO, smooth-muscle contraction, and proliferation of fibroblasts. The mechanism of action of LTRAs leads to their effects on systemic allergic inflammatory processes. [ABSTRACT FROM AUTHOR]

Published
2005
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3. Angiotensin-converting enzyme inhibitors in patients with bronchial responsiveness and asthma.

Author

Kaufman J, Schmitt S, Barnard J, and Busse W

Subjects
Adolescent, Adult, Aged, Angiotensin-Converting Enzyme Inhibitors adverse effects, Asthma drug therapy, Bronchial Hyperreactivity physiopathology, Bronchial Provocation Tests, Cough chemically induced, Double-Blind Method, Drug Tolerance, Enalapril administration & dosage, Enalapril adverse effects, Enalapril analogs & derivatives, Female, Humans, Male, Methacholine Chloride, Middle Aged, Prospective Studies, Single-Blind Method, Angiotensin-Converting Enzyme Inhibitors therapeutic use, Asthma physiopathology, Bronchial Hyperreactivity drug therapy
Abstract

Twenty-one subjects with known bronchial hyperreactivity were prospectively randomized in double-blind fashion to receive one of two angiotensin-converting enzyme inhibitors (ACE-I), enalapril or spirapril, for three weeks. Spirometry and methacholine provocation were performed prior to, during, and following ACE-I usage. Three of 21 subjects developed a nonproductive cough. However, only one subject wheezed slightly. Spirometry and bronchial reactivity (PD20) were unchanged throughout the study.

Published
1992
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7. Rationale for Specific Allergen Testing of Patients With Asthma in the Clinical Pulmonary Office Setting.

Author

Schulman, Edward S. and Pohlig, Carol

Subjects
ALLERGENS, ASTHMA diagnosis, RESPIRATORY diseases, PATIENT education, MEDICAL care standards, DIAGNOSIS methods
Abstract

The article highlights the importance of allergen testing in patients with asthma, as well as advantages and disadvantages associated with existing testing tools like allergen skin testing and in vitro assays. Also mentioned are the contribution of antigen-specific IgE in the development of asthma, available guidelines related to allergen testing including the GINA (Global Initiative for Asthma) guidelines and the importance of patient education.

Published
2015
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8. Bronchial Thermoplasty.

Author

Iyer, Vivek N. and Lim, Kaiser G.

Subjects
ASTHMA treatment, BRONCHIAL diseases, QUALITY of life, ASTHMATICS, THERAPEUTICS
Abstract

The article discusses bronchial thermoplasty (BT), which is the first nonpharmacologic interventional therapy for severe asthma that was authorized by the U.S. Food and Drug Administration (FDA). It claims that BT was approved due to the results of the Asthma Intervention Research (AIR)-2 trial. It explains how thermoplasty is applied, as well as the Asthma Quality of Life Questionnaire (AQLQ), and the asthma-related quality of life (QOL).

Published
2014
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9. Efficacy and Safety of Fluticasone Furoate/Vilanterol Compared With Fluticasone Propionate/Salmeterol Combination in Adult and Adolescent Patients With Persistent Asthma.

Author

Woodcock, Ashley, Bleecker, Eugene R., Lötvall, Jan, O'Byrne, Paul M., Bateman, Eric D., Medley, Hilary, Ellsworth, Anna, Jacques, Loretta, and Busse, William W.

Subjects
FLUTICASONE propionate, SALMETEROL, TREATMENT effectiveness, ASTHMA treatment, ADRENOCORTICAL hormones
Abstract

The article discusses a study which aimed to compare the efficacy of fluticasone furoate/vilanterol (FF/VI) with fluticasone propionate/salmeterol (FP/SAL) in patients with persistent asthma uncontrolled on a medium dose of inhaled corticosteroid (ICS). Results show that there were no difference in reported exacerbations between treatments. It concluded that the efficacy of once-daily FF/VI was similar to bid FP/SAL in improving lung function in patients with persistent asthma.

Published
2013
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10. A Proof-of-Concept, Randomized, Controlled Trial of Omalizumab in Patients With Severe, Difficult-to-Control, Nonatopic Asthma.

Author

Garcia, Gilles, Magnan, Antoine, Chiron, Raphaël, Contin-Bordes, Cécile, Berger, Patrick, Taillé, Camille, Devouassoux, Gilles, de Blay, Frédéric, Couderc, Louis-Jean, Didier, Alain, O'Callaghan, Dermot S., Girodet, Pierre-Olivier, Bourdeix, Isabelle, Le Gros, Vincent, and Humbert, Marc

Subjects
ANTI-immunoglobulin E autoantibodies, ASTHMA in children, PULMONARY function tests, DISEASE exacerbation, AIRWAY (Anatomy)
Abstract

The article discusses a study that investigated the biologic and clinical effects of omalizumab, an anti-immunoglobulin E (IgE) monocolonal antibody, in patients with refractory non-atopic asthma. Findings show that the expression of high-affinity IgE receptor is negatively regulated by omalizumab in patients with severe non-atopic and atopic asthma. The impact of omalizumab on several clinical and laboratory outcomes, including lung function, asthma exacerbations and symptoms are explored.

Published
2013
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11. Does Omalizumab Make a Difference to the Real-life Treatment of Asthma Exacerbations?

Author

Grimaldi- Bensouda, Lamiae, Zureik, Mahmoud, Aubier, Michel, Humbert, Marc, Levy, Jean, Benichou, Jacques, Molimard, Mathieu, and Abenhaim, Lucien

Subjects
ASTHMATICS, ASTHMA treatment, HOSPITAL care, COHORT analysis, SMOKING
Abstract

The article discusses the use of Omalizumab, a humanized antibody, as an add-on therapy alongside standard treatments to reduce severe asthmatic exacerbations. It mentions some methods to perform Omalizumab add-on therapy on a group of adults with uncontrolled severe asthma, and emphasizes the therapy performed by researchers on patients, which concluded that the Omalizumab add-on therapy reduces the risk of hospitalization and emergency department (ED) visits.

Published
2013
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12. Step-Down Compared to Fixed-Dose Treatment With Inhaled Fluticasone Propionate in Asthma.

Author

Foresi, Antonio, Mastropasqua, Berardino, Chetta, Alfredo, D'Ippolito, Raffaele, Testi, Renato, Olivieri, Dario, and Pelucchi, Andrea

Subjects
ASTHMA, SPUTUM, BRONCHIAL spasm, SALIVA, EOSINOPHILS, ADRENOCORTICAL hormones
Abstract

Background: Inhaled corticosteroids (ICSs) are an effective treatment of asthma even when administered at a low dose. Once asthma is controlled, current guidelines recommend that the dose of ICS be reduced to the lowest possible and effective dose. Although the most appropriate strategy for the stepping down has not yet been defined, quantification of sputum eosinophils and bronchial hyperresponsiveness (BHR) are indeed measures of asthma control. Objective: To compare the efficacy of step-down and fixed-dose strategies in the control of BHR to methacholine and eosinophilic inflammation patients with mild-to-moderate asthma. Methods: We performed a double-blind, randomized study to compare inhaled fluticasone propionate (FP), 1,000 μg/d, then reduced to 200 μg/d (group 1; n = 18) to a fixed dose of FP, 200 μg/d (group 2; n = 17) administered for 6 weeks and then 8 weeks in reducing the provocative dose of methacholine causing a 20% fall in FEV1 (PD20) and sputum eosinophils in 35 patients. The duration of the efficacy was also followed subsequently after 8 weeks of placebo treatment. Results: PD20 remarkably increased with both treatment strategies, but differences between groups were not significant. Sputum eosinophils (median values, percentage) at baseline and after each treatment period were not different (group 1, 16.4 to 1.0 to 2.7%; group 2, 16.7 to 2.8 to 2.8%, respectively). The percentages of patients in whom sputum eosinophilia was normalized (< 3%) were as follows: group 1, 69% and 60%; group 2, 50% and 57%. After placebo treatment, sputum eosinophils were still "normalized" in approximately one third of patients. Conclusion: Step-down and fixed-dose strategies with FP improved PD20 and sputum eosinophilia to a similar degree. The effect on sputum eosinophils persisted longer than that on methacholine. [ABSTRACT FROM AUTHOR]

Published
2005
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13. A Single Measure of FEV1 Is Associated With Risk of Asthma Attacks in Long-term Follow-up.

Author

Kitch, Barrett T., Paltiel, A. David, Kuntz, Karen M., Dockery, Douglas W., Schouten, Jan P., Weiss, Scott T., and Fuhlbrigge, Anne L.

Subjects
ASTHMA, ASTHMATICS, PULMONARY function tests, OBSTRUCTIVE lung diseases
Abstract

Background: Clinical practice guidelines for asthma care emphasize the use of objective measures of asthma severity, and yet little data exist on the relationship between FEV1 and asthma outcomes over long-term follow-up. Methods: We explored the association between measures of FEV1 percentage of predicted (FEV1% predicted) and subsequent asthma attacks over 3-year intervals. Subjects were identified from two longitudinal cohort studies conducted in the United States and the Netherlands. Persons were included in the analysis if they reported ever having an attack of wheezing with associated shortness of breath prior to or during the follow-up period Results: Over the course of longitudinal follow-up at 3-year intervals, 195 subjects in the Netherlands cohort contributed 510 observations, and 698 subjects in the US cohort contributed 1,268 observations (for each observation, the report of an attack since their last visit was paired with the subject's FEV1 recorded 3 years prior). Overall, subjects in the Netherlands cohort experienced 114 attacks (22% of the observations) and subjects in the US cohort had 517 attacks (40.6% of the observations). FEV1% predicted was significantly associated with risk of an asthma attack over the 3 years following its measurement. After adjusting for current smoking and gender, FEV1% predicted remained an independent predictor of subsequent asthma attacks. Conclusions: These findings support the use of spirometry as an objective measure of asthma severity and risk of adverse outcomes. [ABSTRACT FROM AUTHOR]

Published
2004
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14. Top ten list in asthma.

Author

Peters, Jay

Subjects
ASTHMA, DRUG therapy for asthma, BRONCHODILATOR agents, COMBINATION drug therapy, CLINICAL trials, TREATMENT effectiveness, BLIND experiment, THERAPEUTICS
Abstract

Presents the abstracts of the top ten studies regarding asthma, compiled as of February 2003.

Published
2003
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15. The Effects of Inhaled Budesonide on Lung Function in Smokers and Nonsmokers With Mild Persistent Asthma

Author

William W. Busse, Carl Johan Lamm, Søren Pedersen, Wan C. Tan, and Paul M. O'Byrne

Subjects
Adult, Male, Pulmonary and Respiratory Medicine, Budesonide, medicine.medical_specialty, Adolescent, medicine.drug_class, Critical Care and Intensive Care Medicine, Placebo, Severity of Illness Index, Gastroenterology, Pulmonary function testing, Young Adult, Double-Blind Method, Forced Expiratory Volume, Bronchodilator, Internal medicine, Administration, Inhalation, Humans, Medicine, Child, Lung, Aged, Asthma, Dose-Response Relationship, Drug, Inhalation, business.industry, Smoking, Respiratory disease, Middle Aged, medicine.disease, Bronchodilator Agents, respiratory tract diseases, Treatment Outcome, Child, Preschool, Anesthesia, Corticosteroid, Female, Cardiology and Cardiovascular Medicine, business, medicine.drug
Abstract

Previous studies have suggested a reduced benefit from therapy with inhaled corticosteroids (ICSs) in asthmatic patients who smoke. The objective of this post hoc study was to study the effects of low-dose inhaled budesonide on lung function in smokers and nonsmokers with mild persistent asthma.Adult patients (age,or= 18 years) in the inhaled Steroid Treatment As Regular Therapy in early asthma (START) study, a 3-year, randomized, placebo-controlled, double-blind study, were stratified according to their smoking habits. The effects on lung function of therapy with budesonide vs placebo were compared in 492 asthmatic patients who smoked habitually and 2,432 nonsmokers.When treated with placebo, newly diagnosed asthmatic patients who smoke had a greater 3-year decline in post-bronchodilator therapy FEV(1), the change being -263.9 mL (SE, 21.8), when compared with nonsmokers on placebo, which was -180.8 mL (SE, 10.6), the mean difference being -83.1 mL (p0.001). Budesonide treatment was associated with a statistically significant 3-year increase in post-bronchodilator therapy FEV(1) in both groups. The effect of budesonide vs placebo was 71.5 mL (p = 0.011) in smokers and 46.5 mL (p = 0.001) in nonsmokers. The corresponding effect in pre-bronchodilator therapy FEV(1) was 118.1 mL (p = 0.002) in smokers and 72.9 mL (p0.001) in nonsmokers.Asthmatic patients who smoke, and are not treated with ICSs, have a greater decline in lung function than asthmatic patients who do not smoke. The benefits of therapy with inhaled budesonide on preventing lung function decline are similar in smokers and nonsmokers with mild persistent asthma.

Published
2009
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16. The poorly explored impact of uncontrolled asthma

Author

Paul M. O'Byrne, William W. Busse, Ella Ekholm, Lars-Goran Carlsson, Michael Schatz, Anders Thorén, and Søren Pedersen

Subjects
Pulmonary and Respiratory Medicine, medicine.medical_specialty, Comorbidity, Critical Care and Intensive Care Medicine, immune system diseases, Adrenal Cortex Hormones, Administration, Inhalation, medicine, Humans, Obesity, Treatment Failure, Disease management (health), Intensive care medicine, Adverse effect, Depression (differential diagnoses), Asthma, Pregnancy, business.industry, Disease Management, medicine.disease, respiratory tract diseases, Pneumonia, Physical therapy, Cardiology and Cardiovascular Medicine, business, Cognition Disorders, Stress, Psychological
Abstract

The goal of asthma management is to achieve disease control; however, despite the availability of effective and safe medications, for many patients asthma remains uncontrolled. One reason for this is the fear of long-term side effects from the regular use of inhaled corticosteroids (ICSs). Adverse effects of poorly controlled asthma (for example, obesity, pneumonia, and risks to the fetus) can be perceived as side effects of ICSs. Poorly controlled asthma adversely affects children's cardiovascular fitness, while children with well-controlled asthma perform at the same level as their peers. Children with uncontrolled asthma also have a higher frequency of obesity than children with controlled asthma. Stress can affect asthma control, and children with poorly controlled asthma are more likely to have learning disabilities compared with those with good control. In adults, focused attention and concentration are negatively affected in patients with untreated asthma, and patients with asthma are at greater risk for depression. Also, poorly controlled asthma increases the risks of severe asthma exacerbations following upper respiratory and pneumococcal pulmonary infections. ICSs used to improve asthma control have been demonstrated to improve all of these outcomes. Lastly, the risks of uncontrolled asthma during pregnancy are substantially greater than the risks of recommended asthma medications. Treatments to maintain asthma control are the best approach to optimize maternal and fetal health in the pregnancies of women with asthma. The maintenance of asthma control has significant advantages to patients and greatly outweighs the potential risks of treatment side effects.

Published
2013
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18. Sputum cathelicidin, urokinase plasminogen activation system components, and cytokines discriminate cystic fibrosis, COPD, and asthma inflammation *

Author

Xiao, Wei, Hsu, Yao-Pi, Ishizaka, Akitoshi, Kirikae, Teruo, and Moss, Richard B.

Subjects
Lung diseases, Obstructive -- Diagnosis, Lung diseases, Obstructive -- Care and treatment, Asthma -- Diagnosis, Asthma -- Care and treatment, Cystic fibrosis -- Diagnosis, Cystic fibrosis -- Care and treatment, Health
Abstract

Background: Interest in airways inflammatory disease has increasingly focused on innate immunity. We investigated several components of innate immunity in induced sputum of patients with cystic fibrosis (CF), COPD, and [...]

Published
2005

19. Short-acting β-agonist prescription fills as a marker for asthma morbidity *

Author

Naureckas, Edward T., Dukic, Vanja, Bao, Xiaoming, and Rathouz, Paul

Subjects
Emergency medical services -- Management, Morbidity -- Risk factors -- Care and treatment -- Diagnosis, Asthma -- Diagnosis -- Care and treatment -- Risk factors, Health, Company business management, Management, Diagnosis, Care and treatment, Risk factors
Abstract

Objectives: Hospital admissions and emergency department (ED) visits have traditionally been-en used to assess the strength of association between environmental exposures, such as air pollution, and asthma morbidity. In the [...]

Published
2005

20. Predicting response to omalizumab, an anti-IgE antibody, in patients with allergic asthma *

Author

Bousquet, Jean, Wenzel, Sally, Holgate, Stephen, Lumry, William, Freeman, Peter, and Fox, Howard

Subjects
Asthma -- Research -- Care and treatment, Health, Care and treatment, Research
Abstract

Study objective: To determine baseline characteristics predictive of response to omalizumab, an anti-IgE antibody, in patients with allergic asthma. Design: Pooled analysis of two multicenter, double-blind, randomized, placebo-controlled phase III [...]

Published
2004

21. A randomized controlled trial of inhaled flunisolide in the management of acute asthma in children *

Author

Nakanishi, Albert K., Klasner, Ann K., and Rubin, Bruce K.

Subjects
Corticosteroids -- Comparative analysis -- Evaluation, Spirometry -- Evaluation -- Comparative analysis, Adrenocortical hormones -- Comparative analysis, Inhaled medication -- Comparative analysis, Statistics -- Comparative analysis, Asthma -- Drug therapy, Health, Drug therapy, Evaluation, Comparative analysis
Abstract

Background: Inhaled corticosteroids (ICS) may provide benefit in the therapy of acute asthma. The purpose of this study was to test the hypothesis that ICS are as effective as oral [...]

Published
2003

22. Effects of varying doses of fluticasone propionate on the physiology and bronchial wall immunopathology in mild-to-moderate asthma *. (clinical investigations)

Author

O'Sullivan, Siobhan, Cormican, Liam, Murphy, Maeve, Poulter, Leonard W., and Burke, Conor M.

Subjects
Fluticasone -- Evaluation -- Dosage and administration, Antiasthmatic agents -- Evaluation -- Dosage and administration, Asthma -- Drug therapy, Health, Drug therapy, Evaluation, Dosage and administration
Abstract

Objectives: Inhaled corticosteroids (ICS) are typically associated with a flat dose-response curve when traditional efficacy values are examined (eg, FE[V.sub.1]). The aim of the present study was to investigate if [...]

Published
2002

23. Fluticasone propionate via the diskhaler or hydrofluoroalkane-134a metered-dose inhaler on methacholine-induced airway hyperresponsiveness *. (clinical investigations)

Author

Langley, Stephen J., Holden, Janet, Derham, Alison, Hedgeland, Paul, Sharma, Raj K., and Woodcock, Ashley

Subjects
Fluticasone -- Evaluation, Antiasthmatic agents -- Evaluation, Health, Evaluation
Abstract

Study objectives: To compare the effect of 4 weeks of treatment with fluticasone propionate (FP), 100 µg bid, delivered either via the Diskhaler (GlaxoSmithKline; Middlesex, UK) or a hydrofluoroalkane (HFA)-134a [...]

Published
2002

24. Two-year retrospective economic evaluation of three dual-controller therapies used in the treatment of asthma *. (clinical investigations)

Author

O'Connor, Richard D., O'Donnell, John C., and Legorreta, Antonio P.

Subjects
Medical care, Cost of -- Analysis -- Economic aspects, Antiasthmatic agents -- Economic aspects -- Analysis, Asthma -- Drug therapy, Health, Drug therapy, Economic aspects, Analysis
Abstract

Objective: To compare asthma-related health-care utilization and expenditures for patients prescribed one of three dual-controller therapies: fluticasone plus salmeterol, inhaled corticosteroids (ICS) [excluding fluticasone] plus salmeterol, and ICS plus a [...]

Published
2002

25. Reduction of eosinophilic inflammation in the airways of patients with asthma using montelukast *. (clinical investigations)

Author

Minoguchi, Kenji, Kohno, Yasurou, Minoguchi, Hideko, Kihara, Norio, Sano, Yasuyuki, Yasuhara, Hajime, and Adachi, Mitsuru

Subjects
Montelukast -- Evaluation, Asthma -- Drug therapy, Health, Drug therapy, Evaluation
Abstract

Objective: Leukotrienes (LTs) are involved in airway eosinophilic inflammation in patients with asthma. We examined the effects of a cysteinyl LT 1-receptor antagonist, montelukast, on sputum eosinophil levels, and the [...]

Published
2002

26. Marginal utility of montelukast for persistent asthma *

Author

Mathison, David A. and Koziol, James A.

Subjects
Singulair (Medication) -- Evaluation -- Product/service Evaluations, Montelukast -- Evaluation -- Product/service Evaluations, Antiasthmatic agents -- Evaluation -- Product/service Evaluations, Asthma -- Drug therapy, Health, Drug therapy, Evaluation
Abstract

Background: The efficacy of a new pharmacologic agent for asthma, in this instance the leukotriene receptor antagonist montelukast, is determined in controlled trials in research subjects. The utility of a [...]

Published
2002

27. Compliance with peak expiratory flow monitoring in home management of asthma

Author

Cote, Johanne, Cartier, Andre, Malo, Jean-Luc, Rouleau, Michel, and Boulet, Louis-Philippe

Subjects
Patient compliance -- Measurement -- Health aspects, Lung volume measurements -- Health aspects -- Measurement, Asthma -- Care and treatment, Health, Care and treatment, Measurement, Health aspects
Abstract

Background: The recent consensus reports on asthma management emphasize the importance of using peak flowmeters to accurately assess the degree of airflow obstruction. However, the optimal way to use those [...]

Published
1998

28. Dose-ranging study of the clinical efficacy of twice-daily triamcinolone acetonide inhalation aerosol in moderately severe asthma

Author

Welch, Michael J., Levy, Sharon, Smith, Joseph A., Feis, Gary, and Farrar, Judith R.

Subjects
Triamcinolone -- Evaluation, Asthma -- Drug therapy, Health, Drug therapy, Evaluation
Abstract

Objectives: This multicenter, double-blind, placebo-controlled study evaluated the dose response to 6 weeks of triamcinolone acetonide inhalation aerosol (TAA, 100 Μg per puff) in patients with moderately severe asthma. Study [...]

Published
1997

29. Pharmacology of leukotriene receptor antagonists: more than inhibitors of bronchoconstriction

Author

Hay, Douglas W.P.

Subjects
Inflammation -- Mediators, Leukotrienes -- Physiological aspects -- Synthesis, Antiasthmatic agents -- Physiological aspects, Asthma -- Causes of -- Physiological aspects, Health, Physiological aspects, Causes of
Abstract

The cysteinyl leukotrienes (LTs) are chemical mediators that are thought to contribute to the pathophysiologic condition of asthma and other inflammatory diseases. The biological effects of the cysteinyl LTs in the lung are pleiotropic, including both bronchoconstrictor and a growing list of nonbronchoconstrictor activities that extend to inflammatory cell recruitment, vascular leakage, mucus production, neuronal dysfunction, and airways remodeling. This spectrum of effects of cysteinyl LTs is consistent with an expanded view of asthma that extends beyond simply bronchoconstriction and inflammation. Consequently, the clinical efficacy of cysteinyl LT receptor antagonists (LTRAs) in asthma may be related to antagonism of more than cysteinyl LT-induced bronchoconstriction. The relationship of antagonism of the multiple effects of cysteinyl LTs by cysteinyl LTRAs to their utility in the therapy of asthma is addressed, and the preclinical and clinical pharmacology of cysteinyl LTRAs is reviewed. (CHEST 1997; 111:35S-45S) Key words: asthma; cysteinyl leukotrienes; cysteinyl leukotriene receptor antagonists; montelukast; pranlukast; zafirlukast, The metabolism of arachidonic acid produces a family-of substances that have diverse biological activities. Significant attention has been focused on the cysteinyl or peptido leukotrienes (LTs, ie, [LTC.sub.4], [LTD.sub.4], and [...]

Published
1997

30. Leukotrienes in the pathogenesis of asthma

Author

O'Byrne, Paul M.

Subjects
Leukotrienes -- Physiological aspects -- Synthesis, Asthma -- Development and progression, Health, Physiological aspects, Development and progression
Abstract

Asthma is a chronic inflammatory disease that is associated with widespread but variable airflow obstruction. The mechanisms that lead to airflow obstruction in asthma are bronchoconstriction, mucosal edema, increased secretion of mucus, and an inflammatory-cell infiltrate that is rich in eosinophils. Leukotrienes (LTs) [B.sub.4], [C.sub.4], [D.sub.4], and [E.sub.4] have been shown experimentally to play a role in each of these inflammatory mechanisms and to mimic the pathologic changes seen in asthma. Inhaled [LTC.sub.4] and [LTD.sub.4] are the most potent bronchoconstrictors yet studied in human subjects. [LTC.sub.4] and [LTD.sub.4] also may cause migration of inflammatory cells into the asthmatic airway. LTs are derived from the 5-lipoxygenase (5-LO) pathway of arachidonic acid metabolism, and increased production of LTs has been demonstrated in patients who have asthma. Leukotriene receptor antagonists and specific inhibitors of the 5-LO pathway hold great promise as new therapies to treat asthma. Because [LTC.sub.4], [LTD.sub.4], and [LTE.sub.4] appear to interact with a common [LTD.sub.4] receptor, selective [LTD.sub.4] receptor antagonists (eg, pranlukast [SB205312/ONO-1078], zafirlukast [ICI 204,219], MK-571, and MK-679), as well as zileuton (A-64077, a direct inhibitor of 5-LO) have been developed as antiasthma agents. Clinical and experimental studies have demonstrated the efficacy of these compounds in reducing not only the symptoms of asthma, but use of [Β.sub.2]-agonists and bronchoconstriction induced by exposure to allergens, exercise, aspirin, and cold air. (CHEST 1997; 111:27S-34S) Key words: allergen; asthma; bronchoconstriction; exercise; leukotriene; leukotriene receptor antagonist; 5-lipoxygenase; mediator, The symptoms of asthma--dyspnea, wheezing, coughing, and chest tightness--are caused by airflow obstruction. Another clinical feature of asthma is increased airway responsiveness to various stimuli.[1] This means that smaller concentrations [...]

Published
1997

31. Association between reported use of inhaled triamcinolone and differential short-term responses to aerosolized albuterol in asthmatics in an emergency department setting

Author

Lin, Robert Y., Newman, Thomas G., Sauter, Diane, Sirleaf, James, Walters, John, Fox, Steve, and Tavakol, Mohammad

Subjects
Triamcinolone -- Dosage and administration -- Physiological aspects, Albuterol -- Physiological aspects -- Dosage and administration, Adrenergic beta agonists -- Physiological aspects -- Dosage and administration, Asthma -- Drug therapy -- Physiological aspects, Health, Drug therapy, Physiological aspects, Dosage and administration
Abstract

Forty-four adult patients with acute asthma were treated with albuterol at a rate of 15 mg/h over 2 h. Analysis of covariance showed a significantly higher baseline adjusted mean for [...]

Published
1994

32. Effect of age on bronchodilator response

Author

Kradjan, Wayne A., Driesner, Nancy K., Abuan, Tammy H., Emmick, Gayle, and Schoene, Robert B.

Subjects
Bronchodilator agents -- Evaluation -- Research, Age factors in disease -- Research, Asthma -- Drug therapy -- Research, Health, Drug therapy, Evaluation, Research
Abstract

Study Objective: Our objective was to compare the differential effects of age and drug type on bronchodilator response. Design: The design was an unblinded, randomized crossover study. Setting: An ambulatory [...]

Published
1992

34. Salmeterol Powder Provides Significantly Better Benefit Than Montelukast in Asthmatic Patients Receiving Concomitant Inhaled Corticosteroid Therapy(*)

Author

Fish, James E., Israel, Elliot, Murray, John J., Emmett, Amanda, Boone, Rebecca, Yancey, Steven W., and Rickard, Kathleen A.

Subjects
Montelukast -- Evaluation, Antiasthmatic agents -- Evaluation, Salmeterol -- Evaluation, Asthma -- Drug therapy, Health, Drug therapy, Evaluation
Abstract

Study objectives: Comparison of inhaled salmeterol powder vs oral montelukast treatment in patients with persistent asthma who remained symptomatic while receiving inhaled corticosteroids. Design: Randomized, double-blind, double-dummy, parallel-group, multicenter trials [...]

Published
2001

35. Evaluation of Blood Vessels and Edema in the Airways of Asthma Patients(*)

Author

Chu, Hong Wei, Kraft, Monica, Rex, Michael D., and Martin, Richard J.

Subjects
Blood vessels -- Physiological aspects -- Health aspects, Clarithromycin -- Health aspects -- Complications and side effects, Pulmonary edema -- Physiological aspects -- Complications and side effects, Airway (Medicine) -- Physiological aspects -- Health aspects, Asthma -- Complications and side effects, Health, Physiological aspects, Complications and side effects, Health aspects
Abstract

Regulation With Clarithromycin Treatment Background: Although airway angiogenesis and edema have been proposed to contribute to the airway remodeling process in patients with asthma, there are few studies looking at [...]

Published
2001

36. A Dose-Ranging Study of Fluticasone Propionate Administered Once Daily via Multidose Powder Inhaler to Patients With Moderate Asthma(*)

Author

Nathan, Robert A., Li, James T. C., Finn, Albert, Jones, Robert, Payne, J. Ellen, Wolford, Jill P., and Harding, Stuart M.

Subjects
Fluticasone -- Dosage and administration, Asthma -- Drug therapy, Health, Drug therapy, Dosage and administration
Abstract

Study objective: This dose-ranging study evaluated the clinical efficacy and safety of inhaled fluticasone propionate administered once daffy via a multidose powder inhaler in patients with moderate asthma ([FEV.sub.1], 45 [...]

Published
2000

37. Health-Related Quality of Life in Moderate Asthma(*): 400 µg Hydrofluoroalkane Beclomethasone Dipropionate vs 800 µg Chlorofluorocarbon Beclomethasone Dipropionate

Author

Juniper, Elizabeth F. and Buist, A. Sonia

Subjects
Beclomethasone dipropionate -- Evaluation, Asthma -- Drug therapy, Health, Drug therapy, Evaluation
Abstract

400 µg Hydrofluoroalkane Beclomethasone Dipropionate vs 800 µg Chlorofluorocarbon Beclomethasone Dipropionate Objective: To compare the effect of hydrofluoroalkane-134a (HFA) beclomethasone dipropionate (BDP; 400 µg/d) with that of chlorofluorocarbon (CFC) BDP [...]

Published
1999

38. Nocturnal Cortisol Secretion in Asthmatic Patients After Inhalation of Fluticasone Propionate(*)

Author

Weiner, Paltiel, Berar-Yanay, Noa, Davidovich, Avi, and Magadle, Rasmi

Subjects
Fluticasone -- Dosage and administration, Hydrocortisone -- Dosage and administration, Asthma -- Physiological aspects, Health, Physiological aspects, Dosage and administration
Abstract

Objectives: This study was designed to assess the relationship between the degree of airflow obstruction and the suppression of the hypothalamic-pituitary-adrenal axis after inhalation of fluticasone propionate (FP) in asthmatic [...]

Published
1999

39. Extra Fine Hydrofluoroalkane-134A Beclomethasone Aerosols

Subjects
Health
Abstract

Selecting an Optimal Inhaled Steroid for an Individual Patient To the Editor: The importance of the development of a reformulation of beclomethasone dipropionate with hydrofluoroalkane (HFA)-134A into a solution that [...]

Published
1999

40. Hydrofluoroalkane-134a Beclomethasone Dipropionate, 400 µg, Is as Effective as Chlorofluorocarbon Beclomethasone Dipropionate, 800 µg, for the Treatment of Moderate Asthma(*)

Author

Gross, Gary, Thompson, Philip J., Chervinsky, Paul, and Burgt, Jennifer Vanden

Subjects
Beclomethasone dipropionate -- Evaluation, Asthma -- Drug therapy, Health, Drug therapy, Evaluation
Abstract

Objective: The improved lung deposition of hydrofluoroalkane-134a beclomethasone dipropionate (HFA-BDP) extrafine aerosol compared with chlorofluorocarbon beclomethasone dipropionate (CFC-BDP) suggests that lower doses of HFA-BDP may be required to provide equivalent [...]

Published
1999

41. Lack of Correlation of Symptoms With Specialist-Assessed Long-term Asthma Severity(*)

Author

Osborne, Molly L., Vollmer, William M., Pedula, Kathryn L., Wilkins, John, Buist, A. Sonia, and O'Hollaren, Mark

Subjects
Physical diagnosis -- Standards -- Physiological aspects, Periodic health examinations -- Standards -- Physiological aspects, Asthma -- Physiological aspects, Health, Standards, Physiological aspects
Abstract

Study objectives: To validate three indicators of asthma severity as defined in the National Asthma Education Program (NAEP) guidelines (ie, frequency of symptoms, degree of airflow obstruction, and frequency of [...]

Published
1999

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