The Effect of Glucocorticoids on Grain Dust-Induced Airway Disease
| Autor: | Matthew W. Nonnenmann, Timothy J. Quinn, Janet L. Watt, Kathy L. Frees, John F. Trapp, David A. Schwartz |
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| Rok vydání: | 1998 |
| Předmět: |
Adult
Male Pulmonary and Respiratory Medicine Spirometry Hydrocortisone Premedication Vital Capacity Anti-Inflammatory Agents Cell Count Critical Care and Intensive Care Medicine Placebo Triamcinolone Acetonide Zea mays Placebos Leukocyte Count FEV1/FVC ratio Forced Expiratory Volume Administration Inhalation Macrophages Alveolar Humans Medicine Single-Blind Method Infusions Intravenous Glucocorticoids Inhalation exposure Cross-Over Studies medicine.diagnostic_test Inhalation Tumor Necrosis Factor-alpha business.industry Interleukin-8 Dust Pneumonia Environmental exposure respiratory system Airway obstruction medicine.disease Crossover study respiratory tract diseases Airway Obstruction Eosinophils Anesthesia Female Cardiology and Cardiovascular Medicine business Bronchoalveolar Lavage Fluid Follow-Up Studies |
| Zdroj: | Chest. 113:505-513 |
| ISSN: | 0012-3692 |
| DOI: | 10.1378/chest.113.2.505 |
| Popis: | Study objectives To determine the effect of glucocorticoids on grain dust-induced airflow obstruction and airway inflammation. Design Randomized controlled trial. Setting University hospital. Participants Health volunteers. Interventions Two randomized, placebo-controlled trials, each studying 10 healthy volunteers who were pretreated with either triamcinolone acetonide (Azmacort) oral inhaler 4 puffs twice daily (800 μg daily) for 7 consecutive days or IV hydrocortisone (3 μg/kg/min) as a 14-h continuous infusion, then subjected to a controlled inhalation exposure to corn dust extract (CDE) (endotoxin exposure dose of 3 pg/kg). A single-blind, crossover study design was performed for each trial enrolling 10 healthy, lifetime nonsmokers, with no history of lung disease or environmental exposure to grain dust. Measurements and results Following each inhalation exposure to CDE, spirometry was performed at regular intervals and BAL was performed at 4 h. Both treatment and placebo groups demonstrated significant decrements in spirometry and increments in BAL cellularity following CDE inhalation compared with placebo. Inhaled steroid treatment resulted in a significantly higher FEV 1 only at the 2-h time point following CDE inhalation with no significant differences observed in the BAL total cell concentration or cellular differential compared with placebo. IV hydrocortisone treatment resulted in a significantly higher FEV 1 and FVC between 2 and 4 h after CDE inhalation, as well as significant reductions in the BAL total cell, macrophage, and eosinophil concentrations. Interestingly, the concentration of tumor necrosis factor-α and interleukin-8 in the BAL fluid was also decreased following treatment with IV glucocorticoids. Conclusions These results demonstrate that glucocorticoids, administered IV and perhaps by inhalation, have a mildly protective effect on airflow obstruction and airway inflammation induced by inhalation of grain dust. |
| Databáze: | OpenAIRE |
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