Am. J. Respir. Crit. Care Med., Volume 165, Number 1, January 2002, 15-21

Effect of Budesonide on the Perception of Induced Airway Narrowing in Subjects with Asthma

CHERYL M. SALOME, HELEN K. REDDEL, SANDRA I. WARE, ALYSON M. ROBERTS, CHRISTINE R. JENKINS, GUY B. MARKS, and ANN J. WOOLCOCK

Institute of Respiratory Medicine, University of Sydney, Sydney, New South Wales, Australia

The perception of bronchoconstriction may be modulated by airway inflammation. However, the effect of inhaled corticosteroid (ICS) treatment on perception in subjects with asthma has received limited study. The aim of this study was to determine the effect of inhaled budesonide on the perception of breathlessness induced by histamine challenge. Thirty-five subjects with poorly controlled asthma were randomized to receive budesonide (1,600 or 3,200 µg/d) for 8 wk, followed by 8 wk at 1,600 µg/d and subsequent downtitration according to a clinical algorithm. Borg scores were recorded during histamine challenges performed at baseline and at 8, 16, 24, 48, and 72 wk. Perception was estimated as the slope of Borg/% fall FEV₁. The Borg/FEV₁ slope increased significantly after 8 wk of budesonide (0.09 [0.08-0.12] to 0.15 [0.11-0.19], p = 0.002), and remained increased compared with baseline values at all subsequent visits. There were no significant differences in Borg/ FEV₁ slope between subjects who were and were not taking ICS at study entry. The magnitude of change in the Borg/FEV₁ slope did not differ significantly between treatment groups and was not related to changes in baseline FEV₁, airway hyperresponsiveness, blood eosinophils, or serum eosinophil cationic protein (ECP). We conclude that treatment with budesonide enhances the perception of airway narrowing, but the effect is unrelated to budesonide dose, or to changes in circulating eosinophil markers.

This article has been cited by other articles:

				A. Deesomchok, T. Fisher, K. A. Webb, J. Ora, Y.-M. Lam, M. D. Lougheed, and D. E. O'Donnell Effects of Obesity on Perceptual and Mechanical Responses to Bronchoconstriction in Asthma Am. J. Respir. Crit. Care Med., January 15, 2010; 181(2): 125 - 133. [Abstract] [Full Text] [PDF]

				R. van Gent, L. E. M. van Essen-Zandvliet, M. M. Rovers, J. L. L. Kimpen, G. de Meer, and C. K. van der Ent Poor perception of dyspnoea in children with undiagnosed asthma Eur. Respir. J., November 1, 2007; 30(5): 887 - 891. [Abstract] [Full Text] [PDF]

				J. F. Donohue and J. A. Ohar Effects of Corticosteroids on Lung Function in Asthma and Chronic Obstructive Pulmonary Disease Proceedings of the ATS, November 1, 2004; 1(3): 152 - 160. [Abstract] [Full Text] [PDF]

				D.J. Eckert, P.G. Catcheside, and R.D. McEvoy Blunted sensation of dyspnoea and near fatal asthma Eur. Respir. J., August 1, 2004; 24(2): 197 - 199. [Full Text] [PDF]

				C M Salome, J D Leuppi, R Freed, and G B Marks Perception of airway narrowing during reduction of inhaled corticosteroids and asthma exacerbation Thorax, December 1, 2003; 58(12): 1042 - 1047. [Abstract] [Full Text] [PDF]

				E. R. McFadden Jr. Acute Severe Asthma Am. J. Respir. Crit. Care Med., October 1, 2003; 168(7): 740 - 759. [Abstract] [Full Text] [PDF]

				S Panditi and M Silverman Perception of exercise induced asthma by children and their parents Arch. Dis. Child., September 1, 2003; 88(9): 807 - 811. [Abstract] [Full Text] [PDF]

				F. Laghi and M. J. Tobin Disorders of the Respiratory Muscles Am. J. Respir. Crit. Care Med., July 1, 2003; 168(1): 10 - 48. [Abstract] [Full Text] [PDF]

				M. J. Tobin Asthma, Airway Biology, and Nasal Disorders in AJRCCM 2002 Am. J. Respir. Crit. Care Med., February 1, 2003; 167(3): 319 - 332. [Full Text] [PDF]