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Division of Pulmonary and Critical Care Medicine, University of Miami at Mount Sinai Medical Center, Miami Beach, Florida 33140
Airway
inflammation characterized by neutrophils and free elastase contributes
to allergic mucociliary dysfunction. Glucocorticosteroids are the most
important anti-inflammatory agents used in the treatment of asthma, but
their effect on allergic mucociliary dysfunction is not known.
Therefore, we assessed both the prophylactic and therapeutic effects of
the glucocorticosteroid budesonide on antigen-induced mucociliary
dysfunction in sheep. Tracheal mucus velocity (TMV), a
marker of mucociliary clearance, was measured by using a
roentgenographic technique. When budesonide was administered either 30 min before or 1 h after airway challenge with Ascaris
suum, the antigen-induced fall in TMV at 6 h was
prevented. The effects on TMV at 8 and 24 h after challenge were also
determined when budesonide and, for comparative purposes,
1-protease inhibitor were given
6 h after antigen challenge. Budesonide treatment improved TMV at 8 h,
but TMV was not significantly different from antigen alone at 24 h.
Treatment with
1-protease
inhibitor, however, caused only a significant reversal of the
antigen-induced fall in TMV at 24 h after challenge; this indicates a
more prolonged effect than budesonide. Our results suggest that
antiproteases may have a potential role as a therapeutic approach to
mucociliary dysfunction in asthma and provide evidence for another
means by which glucocorticosteroids contribute to the control of the
disease.
mucociliary clearance; asthma; secretions; corticosteroids; elastase inhibitors
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