Treatment approaches in small bronchi inflammatory control in bronchial asthma patients



Cite item

Full Text

Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription or Fee Access

Abstract

This article reviews the significance of distal airways inflammation in asthma, current methods of investigations
and therapeutic approaches to control inflammation at the level of small bronchi.
It is demonstrated that inflammation in most asthma patients involves all airways including the small bronchi.
The new drugs targeting distal airways, including extrafine formulations of inhaled steroids and P2-agonists
(beclomethazone/formoterol (Fostair), can successfully treat pathologic process in small bronchi of asthma
patients.

About the authors

A V Budnevskiy

Voronezh N.N. Burdenko State Medical Academy

Email: budnev@list.ru
Voronezh N.N. Burdenko State Medical Academy

V T Burlachuk

Voronezh N.N. Burdenko State Medical Academy

Voronezh N.N. Burdenko State Medical Academy

LA Olisheva

Voronezh N.N. Burdenko State Medical Academy

Voronezh N.N. Burdenko State Medical Academy

References

  1. Beasley R. The Global Burden of Asthma Report, Global Initiative for Asthma (GINA). Available from <http://www>.ginasthma.org <http://ginasthma.org>. 2004.
  2. MasoliM., FabianD., Holt S., Beasley R. The global burden of asthma: executive summary of the GINA Dissemination Committee report. Allergy. 2004, v. 59, p. 469-478.
  3. Bousquet J., Jeffery P.K., Busse W.W. et al. Asthma. From bronchoconstriction to airways inflammation and remodeling. Am. J. Respir. Crit. Care Med., 2000, v. 161, No. 5. p. 1720-1745.
  4. Cohn L., Elias J.A., Chupp G.L. Asthma: mechanisms of disease persistence and progression. Ann. Rev. Immunol. 2004, v. 22. p. 789-815.
  5. GINA Report, Global Strategy for Asthma Management and Prevention. Updated December. 2009.
  6. Vignola A.M., Mirabella F, Costanzo G. et al. Airway remodeling in asthma. Chest. 2003, v. 123. p. 417-422.
  7. Royce S.G., Tang M.L. The effects of current therapies on airway remodeling in asthma and new possibilities for treatment and prevention. Curr. Mol. Pharmacol. 2009, No. 2, v. 2, p. 169-181.
  8. Corren J. Small airways disease in asthma. Curr. Allergy Asthma Rep. 2008, v. 8. p. 533-539.
  9. Tulic M.K., Christodoulopoulos P., Hamid Q. Small airway inflammation in asthma. Respir. Res. 2001, v. 2. p. 333-339.
  10. Яшина Л. А. Особенности бронхиальной астмы с тяжелым течением. Здоровье Украины. 2010, № 1. с. 6-8.
  11. ContoliM., Bousquet J., FabbriL.M. etal. The small airways and distal lung compartment in asthma and COPD: a time for reappraisal. Allergy. 2010, v. 65. p. 141-151.
  12. Ериппи М.А. Патофизиология легких. М., Восточная книжная компания. 1997. 344 с.
  13. Организация работы по исследованию функционального состояния легких методами спирографии и пневмотахографии и применение этих методов в клинической практике. Методические указания. Минск. 2002.77 с.
  14. Booker R. Interpretation and evaluation of pulmonary function tests. Nurs. Stand. 2009, v. 23, p. 46-56.
  15. Schneider A, Gindner L., Tilemann L. et al. Diagnostic accuracy of spirometry in primary care. BMCPulm. Med. 2009, v. 10, p. 9-31.
  16. MillerM.R., HankinsonJ., BrusascoV. etal. Standardization of spirometry. Series «ATS/ERS TASK FORCE: Standardization of Lung Function Testing». Eur. Respir. J. 2005, v. 26, p. 319-338.
  17. Kraft M., Cairns C.B., Ellison M.C. et al. Improvements in distal lung function correlate with asthma symptoms after treatment with oral Montelukast. Chest. 2006, v. 130, p. 1726-1732.
  18. Полянская М.А. Бодиплетизмография и исследование DLCO - методика проведения и интерпретация результатов. Здоровье Украины. 2008, № 9/1, с. 52-53.
  19. Ярцев С. С. Структурный анализ диагностической эффективности показателей бодиплетизмографии у больных бронхиальной астмой. Медицинская техника. 2005, № 3, с. 21-23.
  20. Levitzky M.G. Pulmonary Physiology, 7th Ed, McGraw-Hill (Lange Series). 2007, 280 p.
  21. Яшина Л.А., Полянская М.А, Загребельный М.Р. Импульсная осциллометрия - новые возможности в диагностике и мониторинге обструктивных заболеваний легких. Здоровье Украины. 2009, № 23/1, с. 26-27.
  22. Kaminsky D.A., Irvin C.G., Lundblad L. et al. Oscillation mechanics of the human lung periphery in asthma. J. Appl. Physiol. 2004. v. 97, p. 1849-1858.
  23. Winkler J., Hagert-Wmkler A., Wirtz H. et al. Impulse oscillometry in the diagnosis of the severity of obstructive pulmonary disease. Pneumologie. 2009, v. 63, p. 266-275.
  24. Goldman M.D. Clinical application of forced oscillation. Pulm. Pharmacol. Ther. 2001, v. 14, p. 341-350.
  25. BourdinA., PaganinE, PrefautC. etal. Nitrogen washout slope in poorly controlled asthma. Allergy. 2006, v. 61, p. 85-89.
  26. In'tVeenJ.C, BeekmanAJ., BelE.H, SterkPJ. Recurrent exacerbations in severe asthma are associated with enhanced airway closure during stable episodes. Am. J. Respir. Crit. Care Med. 2000, v. 161, p. 1902-1906.
  27. Magnussen H, Holz O. Monitoring airway inflammation in asthma by induced sputum. Eur. Respir. J. 1999, v. 13, p. 5-7.
  28. TsoumakidouM., TzanakisN, SiafakasN.M. Induced sputum in the investigation of airway inflammation of COPD. Respir. Med., 2003, v. 97. p. 863-871.
  29. Cohen J., Douma W.R., ten Hacken N.H. et al. Ciclesonide improves measures of small airway invvement in asthma. Eur. Respir. J. 2008, v. 31, p. 1213-1220.
  30. van Veen I.H., Sterk P.J., Schot R. et al. Alveolar nitric oxide versus measures of peripheral airway dysfunction in severe asthma. Eur. Respir. J. 2006, v. 27, p. 951-956.
  31. Kosciuch J., Krenke R., Gorska K. et al. Relationship between airway wall thickness assessed by high-resolution computed tomography and lung function in patients with asthma and chronic obstructive pulmonary disease. J. Physiol. Pharmacol. 2009, v. 60. suppl. 5, p. 71-76.
  32. Mikos M., Grzanka P., Sladek К et al. High-Resolution Computed Tomography Evaluation of Peripheral Airways in Asthma Patients: Comparison of Focal and Diffuse Air Trapping. Respiration. 2009, v. 77, p. 381-388.
  33. de Jong P.A., MullerN.L, Pare P.D., CoxsonH.O. Computed tomographic imaging of the airways: relationship to structure and function. Eur. Respir. J. 2005, v. 26, p. 140-152.
  34. Awadh N., MullerN.L., Park C.S. et al. Airway wall thickness in patients with near fatal asthma and control groups: assessment with high resolution computed tomographic scanning. Thorax. 1998, v. 53, p. 248-253.
  35. Goldin J.G., Tashkin D.R, Kleerup E.C. etal. Comparative effects of hydrofluoroalkane and chlorofluorocarbonbeclometh-asone dipropionate inhalation on small airways: assessment with functional helical thin section computed tomography. J. Allergy Clin. Immunol. 1999, v. 104, p. 258-267.
  36. Kauczor H.U., Chen X.J., van Beek E.J., Schreiber W.G. Pulmonary ventilation imaged by magnetic resonance: at the doorstep of clinical application. Eur. Respir. J. 2001, v. 17, p. 1008-1023.
  37. Samee S., Altes T, Powers P. Imaging the lungs in asthmatic patients by using hyperpolarized helium-3 magnetic resonance: assessment of response to methacholine and 36. 36. exercise challenge. J. Allergy Clin. Immunol. 2003, v. III, p. 1205-1211.
  38. Fain S.B., Korosec F.R., Holmes J.H. et al. Functional lung imaging using hyperpolarized gas MRL J. Magn. Reson. Imaging. 2007, v. 25, p. 910-923.
  39. Bai T.R., Knight D.A. Structural changes in the airways in asthma: observations and consequences. Clin. Sci (Lond). 2005, v. 108, p. 463-477.
  40. Boxall C, Holgate S.T, Davies D.E. The contribution of transforming growth factor and epidermal growth factor signaling to airway remodeling in chronic asthma. Eur. Respir. J. 2006. v. 27, p. 208-229.
  41. Sutherland E.R, Martin R.J. Distal lung inflammation in asthma. Ann. Allergy Asthma Immunol. 2002, v. 89, p. 119-124.
  42. Leach C.L., Davidson P.J., Boudreau R.J. Improved airway targeting with the CFC-free HFA-beclomethasone metered dose inhaler compared with CFC-beclomethasone. Eur. Respir. J. 1998, v. 12, p. 1346-1353.
  43. Powell H., Gibson P.G. Inhaled corticosteroid doses in asthma: an evidence based approach. Med. J. Aust. 2003, v. 178, p. 223-225.
  44. Szefler S J., Martin R.J., King TS. et al. Significant variability in response to inhaled corticosteroids for persistent asthma. J. Allergy Clin. Immunol. 2002, v. 109, p. 410-418.
  45. VanSchayckCE, DonnellD. The efficacy and safety of QVAR (hydrofiuoroalkane-beclometasone diproprionate extrafine aerosol) in asthma (part 1): an update of clinical experience in adults. Int. J. Clin. Pract. 2004, v. 58, p. 678-688.
  46. Hauber H.P., Taha R., Bergeron C. et al. Effects of hydrofiuo-roalkane and dry powder formulated corticosteroids on sputum inflammatory markers in asthmatic patients. Can. Respir. J. 2006, v. 13, p. 73-78.
  47. Milic-Emili J. Does mechanical injury ofthe peripheral airways play a role in the genesis of COPD in smokers? COPD. 2004, v. 1, p. 85-92.
  48. Bousquet J. Introduction. Modulite: simplifying the changeover. Respir. Med. 2002, v. 96, suppl. D. sl-s2.
  49. Huchon G., Magnussen H., Chuchalin A etal. Lung function and asthma control with beclomethasone and formoterol in a single inhaler. Respir. Med. 2009, v. 103, p. 41-49.
  50. Papi A, Paggiaro P.L., NicoliniG etal. Beclomethasone/for-moterol versus budesonide/formoterol combination therapy in asthma. Eur. Respir. J. 2007, v. 29, p. 682-689.
  51. Papi A, Paggiaro P., Nicolini G et al. Beclomethasone/for-moterol vs fluticasone/salmeterol inhaled combination in moderate to severe asthma. Allergy. 2007, v. 62, p. 1182-1188.
  52. Vanden Burgt J.A., Busse W.W, Martin R.J. et al. Efficacy and safety overview of a new inhaled corticosteroid, QVAR (hydrofluoroalkane-beclomethasone extrafine inhalation aerosol), in asthma. J. Allergy Clin. Immunol. 2000, v. 106, p. 1209-1226.

Supplementary files

Supplementary Files
Action
1. JATS XML
Download

Copyright © Pharmarus Print Media, 2009



This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies