Am. J. Respir. Crit. Care Med., Volume 161, Number 1, January 2000, 293-296

Effect of an Inhaled Glucocorticosteroid on Airway Mucosal Blood Flow in Mild Asthma

JORGE L. BRIEVA, IGNACIO DANTA, and ADAM WANNER

Division of Pulmonary and Critical Care Medicine, University of Miami School of Medicine, Miami, Florida

We determined airway mucosal blood flow (aw) and FEV ₁ before and after inhaled albuterol in 19 glucocorticosteroid (GS)-naive patients with mild intermittent asthma, and assessed the effects of a 2-wk course of fluticasone propionate (FP; 440 µg daily) on these parameters. Twelve healthy nonsmokers served as controls. Baseline aw was 55.5 ± 0.7 µl/min/ml (mean ± SE) in the asthmatic subjects and 44.2 ± 0.7 µl/min/ml in the controls; the respective FEV₁ values were 2.8 ± 0.2 L and 3.4 ± 0.2 L (p < 0.01 for both parameters). Albuterol increased aw by 27 ± 3% in the control subjects (p < 0.01) but had no effect on aw in the asthmatic subjects; it increased FEV ₁ by 7 ± 1% and 6 ± 1% in the two groups, respectively. aw decreased to 49.2 ± 0.8 µl/min/ml (p < 0.05 versus baseline), and the aw responsiveness to albuterol was restored ( +21 ± 2%; p < 0.05) in the asthmatic subjects after FP. Eleven asthmatic subjects stopped using FP at this time; 2 wk later, their aw returned to baseline (55.2 ± 0.9 µl/min/ml) and they lost the aw responsiveness to albuterol. Mean ( ± SE) FEV₁ and FEV₁ responsiveness to albuterol were not affected by FP. The GS-sensitive increase in aw and its hyporesponsiveness to albuterol in asthmatic subjects may be consequences of airway inflammation. Brieva JL, Danta I, Wanner A. Effect of an inhaled glucocorticosteroid on airway mucosal blood flow in mild asthma.

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