PV Gardiner, C Ward, H Booth, A Allison, DJ Hendrick and EH Walters
Chest Unit, Newcastle General Hospital, Newcastle Upon Tyne, United Kingdom.

Using BAL, we studied the effects of 8 wk of treatment with salmeterol on airway inflammation in nine asthmatic subjects in a double-blind crossover placebo-controlled protocol. The study patients were all receiving regular inhaled corticosteroid therapy (400 to 1,000 micrograms beclomethasone dipropionate per day) and inhaled albuterol for symptomatic relief, i.e., subjects who might be considered suitable for treatment with salmeterol. The asthmatic group had significant differences in numbers of epithelial cells and eosinophils in BAL compared with a group of 15 normal control subjects (p < 0.01). During salmeterol treatment mean morning and evening peak flow rates were increased (p < 0.05). There was no significant change in BAL cell profile and no change in percentages of CD4 and CD8 lymphocytes or proportion of lymphocytes expressing HLA-DR after salmeterol. In conclusion, we were unable to demonstrate any significant anti- inflammatory effect of regular salmeterol therapy on airway inflammation using BAL in these asthmatic patients. At the same time, there was equally no evidence of a deterioration in the underlying inflammatory disease process.

This article has been cited by other articles:

				G. P. Currie, D. K. C. Lee, and P. Srivastava Long-Acting Bronchodilator or Leukotriene Modifier as Add-on Therapy to Inhaled Corticosteroids in Persistent Asthma? Chest, October 1, 2005; 128(4): 2954 - 2962. [Abstract] [Full Text] [PDF]

				G.P. Currie, P. Srivastava, O.J. Dempsey, and D.K.C. Lee Therapeutic modulation of allergic airways disease with leukotriene receptor antagonists QJM, March 1, 2005; 98(3): 171 - 182. [Abstract] [Full Text] [PDF]

				G.P. Currie, C.M. Jackson, S.A. Ogston, and B.J. Lipworth Airway-stabilizing effect of long-acting {beta}2-agonists as add-on therapy to inhaled corticosteroids QJM, June 1, 2003; 96(6): 435 - 440. [Abstract] [Full Text] [PDF]

				G. P. Currie, D. K. C. Lee, K. Haggart, C. E. Bates, and B. J. Lipworth Effects of Montelukast on Surrogate Inflammatory Markers in Corticosteroid-treated Patients with Asthma Am. J. Respir. Crit. Care Med., May 1, 2003; 167(9): 1232 - 1238. [Abstract] [Full Text] [PDF]

				M J Vaquerizo, P Casan, J Castillo, M Perpina, J Sanchis, V Sobradillo, A Valencia, H Verea, J L Viejo, C Villasante, et al. Effect of montelukast added to inhaled budesonide on control of mild to moderate asthma Thorax, March 1, 2003; 58(3): 204 - 210. [Abstract] [Full Text] [PDF]

				P A Beckett and P H Howarth Pharmacotherapy and airway remodelling in asthma? Thorax, February 1, 2003; 58(2): 163 - 174. [Abstract] [Full Text] [PDF]

				E. Bacci, A. Di Franco, M.L. Bartoli, S. Carnevali, S. Cianchetti, F.L. Dente, D. Giannini, B. Vagaggini, L. Ruocco, and P.L. Paggiaro Comparison of anti-inflammatory and clinical effects of beclomethasone dipropionate and salmeterol in moderate asthma Eur. Respir. J., July 1, 2002; 20(1): 66 - 72. [Abstract] [Full Text] [PDF]

				J. C. KIPS and R. A. PAUWELS Long-acting Inhaled beta 2-Agonist Therapy in Asthma Am. J. Respir. Crit. Care Med., September 15, 2001; 164(6): 923 - 932. [Full Text] [PDF]

				S. J. WILSON, A. WALLIN, G. DELLA-CIOPPA, T. SANDSTROM, and S. T. HOLGATE Effects of Budesonide and Formoterol on NF-kappa B, Adhesion Molecules, and Cytokines in Asthma Am. J. Respir. Crit. Care Med., September 15, 2001; 164(6): 1047 - 1052. [Abstract] [Full Text] [PDF]

				S. C. Lazarus, H. A. Boushey, J. V. Fahy, V. M. Chinchilli, R. F. Lemanske Jr, C. A. Sorkness, M. Kraft, J. E. Fish, S. P. Peters, T. Craig, et al. Long-Acting {beta}2-Agonist Monotherapy vs Continued Therapy With Inhaled Corticosteroids in Patients With Persistent Asthma: A Randomized Controlled Trial JAMA, May 23, 2001; 285(20): 2583 - 2593. [Abstract] [Full Text] [PDF]

				R. F. Lemanske Jr, C. A. Sorkness, E. A. Mauger, S. C. Lazarus, H. A. Boushey, J. V. Fahy, J. M. Drazen, V. M. Chinchilli, T. Craig, J. E. Fish, et al. Inhaled Corticosteroid Reduction and Elimination in Patients With Persistent Asthma Receiving Salmeterol: A Randomized Controlled Trial JAMA, May 23, 2001; 285(20): 2594 - 2603. [Abstract] [Full Text] [PDF]

				W. J. CALHOUN, K. L. HINTON, and J. J. KRATZENBERG The Effect of Salmeterol on Markers of Airway Inflammation Following Segmental Allergen Challenge Am. J. Respir. Crit. Care Med., March 15, 2001; 163(4): 881 - 886. [Abstract] [Full Text]

				I. Aziz, A. M. Wilson, and B. J. Lipworth Effects of Once-Daily Formoterol and Budesonide Given Alone or in Combination on Surrogate Inflammatory Markers in Asthmatic Adults Chest, October 1, 2000; 118(4): 1049 - 1058. [Abstract] [Full Text] [PDF]

				J. BOUSQUET, P. K. JEFFERY, W. W. BUSSE, M. JOHNSON, and A. M. VIGNOLA Asthma . From Bronchoconstriction to Airways Inflammation and Remodeling Am. J. Respir. Crit. Care Med., May 1, 2000; 161(5): 1720 - 1745. [Full Text]

				J. C. KIPS, B. J. O'CONNOR, M. D. INMAN, K. SVENSSON, R. A. PAUWELS, and P. M. O'BYRNE A Long-term Study of the Antiinflammatory Effect of Low-dose Budesonide Plus Formoterol versus High-dose Budesonide in Asthma Am. J. Respir. Crit. Care Med., March 1, 2000; 161(3): 996 - 1001. [Abstract] [Full Text] [PDF]

				X. LI, C. WARD, F. THIEN, R. BISH, T. BAMFORD, X. BAO, M. BAILEY, J. W. WILSON, and E. HAYDN WALTERS An Antiinflammatory Effect of Salmeterol, a Long-acting beta 2 Agonist, Assessed in Airway Biopsies and Bronchoalveolar Lavage in Asthma Am. J. Respir. Crit. Care Med., November 1, 1999; 160(5): 1493 - 1499. [Abstract] [Full Text]

				B. J. Lipworth The Emerging Role of Leukotriene Antagonists in Asthma Therapy Chest, February 1, 1999; 115(2): 313 - 316. [Full Text] [PDF]

				A. WALLIN, T. SANDSTRÖM, M. SÖDERBERG, P. HOWARTH, B. LUNDBÄCK, G. DELLA-CIOPPA, S. WILSON, M. JUDD, S. HOLGATE, A. LINDBERG, et al. The Effects of Regular Inhaled Formoterol, Budesonide, and Placebo on Mucosal Inflammation and Clinical Indices in Mild Asthma Am. J. Respir. Crit. Care Med., January 1, 1999; 159(1): 79 - 86. [Abstract] [Full Text]

				J. Seybold, R. Newton, L. Wright, P. A. Finney, N. Suttorp, P. J. Barnes, I. M. Adcock, and M. A. Giembycz Induction of Phosphodiesterases 3B, 4A4, 4D1, 4D2, and 4D3 in Jurkat T-cells and in Human Peripheral Blood T-lymphocytes by 8-Bromo-cAMP and Gs-coupled Receptor Agonists. POTENTIAL ROLE IN beta 2-ADRENORECEPTOR DESENSITIZATION J. Biol. Chem., August 7, 1998; 273(32): 20575 - 20588. [Abstract] [Full Text] [PDF]

				R. J. Harbeck Clin. Vaccine Immunol., May 1, 1998; 5(3): 271 - 277. [Full Text]

				R. S. Peebles Jr., S. Permutt, and A. Togias Rapid reversibility of the allergen-induced pulmonary late-phase reaction by an intravenous beta 2-agonist J Appl Physiol, May 1, 1998; 84(5): 1500 - 1505. [Abstract] [Full Text] [PDF]

				P. J. BARNES, S. PEDERSEN, and W. W. BUSSE Efficacy and Safety of Inhaled Corticosteroids . New Developments Am. J. Respir. Crit. Care Med., March 1, 1998; 157(3): S1 - 53. [Full Text] [PDF]

				R. A. Pauwels, C.-G. Lofdahl, D. S. Postma, A. E. Tattersfield, P. O'Byrne, P. J. Barnes, A. Ullman, and The Formoterol and Corticosteroids Establishing Th Effect of Inhaled Formoterol and Budesonide on Exacerbations of Asthma N. Engl. J. Med., November 13, 1997; 337(20): 1405 - 1411. [Abstract] [Full Text] [PDF]

				R. F. LEMANSKE JR. and D. B. ALLEN Choosing a Long-term Controller Medication in Childhood Asthma . The Proverbial Two-edged Sword Am. J. Respir. Crit. Care Med., September 1, 1997; 156(3): 685 - 687. [Full Text] [PDF]

				A. A. P. H. VERBERNE, C. FROST, R. J. ROORDA, H. van der LAAG, K. F. KERREBIJN, and The Dutch Paediatric Asthma Study Group One Year Treatment with Salmeterol Compared with Beclomethasone in Children with Asthma Am. J. Respir. Crit. Care Med., September 1, 1997; 156(3): 688 - 695. [Abstract] [Full Text] [PDF]

				H. S. Nelson {beta}-Adrenergic Bronchodilators N. Engl. J. Med., August 24, 1995; 333(8): 499 - 507. [Full Text] [PDF]