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Am. J. Respir. Crit. Care Med., Volume 164, Number 12, December 2001, 2172-2176

Budesonide Reduces Neutrophilic but Not Functional Airway Response to Ozone in Mild Asthmatics

BARBARA VAGAGGINI, MAURO TACCOLA, ILARIA CONTI, STEFANO CARNEVALI, SILVANA CIANCHETTI, MARIA LAURA BARTOLI, ELENA BACCI, FEDERICO L. DENTE, ANTONELIA DI FRANCO, DANIELE GIANNINI, and PIER LUIGI PAGGIARO

Cardiothoracic Department, Ospedale Cisanello, Pisa, Italy

Ambient ozone concentration is related to asthma exacerbation, but few findings are available regarding the effects of pharmacologic asthma treatment on this relationship. The purpose of this study was to investigate whether inhaled corticosteroids inhibit ozone-induced airway neutrophilic inflammation, as detected in induced sputum, and reduce functional response to ozone exposure. Eleven subjects with mild persistent asthma were exposed for 2 h, on separate days, to 0.27 ppm ozone and to air in random order, before and after 4 wk of treatment with budesonide (400 µg twice daily). Before exposure, 1 and 2 h after the beginning of exposure, and 6 h after the end of exposure, pulmonary function was measured, and a total symptom score questionnaire was completed; 6 h after exposure, sputum was induced with hypertonic saline. Budesonide treatment did not inhibit the functional response to ozone exposure, as determined by reduction in FEV1 and increase in total symptom score, but it significantly blunted the increase in the percentage of sputum neutrophils and interleukin-8 concentrations in the supernatant (p < 0.05). Therefore, 4 wk of inhaled budesonide blunted the airway neutrophilic inflammatory response but did not prevent the functional impairment of the airways after ozone exposure.




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