Some aspects of therapyresistance in patients with, atopic moderate-to-severe asthma
Abstract
The aim was to study some reasons of therapy-resistance in patients with moderate-to-severe atopic bronchial asthma. Thirty-five moderate-to-severe atopic bronchial asthma patients were treated with inhaled "Flixotide" (GlaxoWellcome) 1000 meg daily and "Serevent" (GlaxoWellcome) 100 meg daily for three months. Changes in clinical and functional features and IL-4, IL-5, TNFα levels in serum were studied. Most of patients (80%) have achieved goals of asthma therapy (E.Bateman's criteria, 1999) after 12 weeks of the therapy. Seven patients demonstrated a therapy-resistance in our study. They have not got positive changes in clinical and functional features and IL-4, IL-5, TNFα sera levels. So, one of the reasons of the therapy-resistance in the patients tested is thought to be the cytokines imbalance.
About the Authors
L. M. Ogorodova
Сибирский медицинский университет
Russian Federation
Russian Federation
O. S. Kobyakova
Сибирский медицинский университет
Russian Federation
Russian Federation
F. I. Petrovsky
Сибирский медицинский университет
Russian Federation
Russian Federation
F. l. Abazova
ГлаксоСмитКляйн; Московское представительство
Russian Federation
Russian Federation
Yu. A. Petrovskaya
Сибирский медицинский университет
Russian Federation
Russian Federation
A. V. Salnikov
Сибирский медицинский университет
Russian Federation
Russian Federation
References
1. Difficult/therapy-resistant asthma. ERS Task Force on difficult/therapy-resistant asthma. Eur. Respir. J. 1999; 13: 1198.
2. Leung D.Y., Spahn J.D., Szefler S.J. Immunologic basis and management of steroid-resistant asthma. Allergy Asthma Proc. 1999; 20: 9-14.
3. Leung D.Y., Szefler S.J. Diagnosis and management of steroidresistant asthma. Clin, in Chest Med. 1997; 18 (3): 611-625.
4. Leung D.Y., de Castro М., Szefler S.J., Chrousos G.P. Mechanisms of glucocorticoid-resistant asthma. Ann. N.Y. Acad. Sci. 1998; 840: 735-746.
5. Corrigan C.J., Brown P.H., Barnes N.C. et al. Glucocorticoid resistance in chronic asthma: Glucocorticoid pharmacokinetics, glucocorticoid receptor characteristics, and inhibition of peripheral blood T-cell proliferation by glucocorticoids in vitro. Am. Rev. Respir. Dis. 1991; 144: 1016.
6. Global initiative for asthma. Global strategy for astma management and prevention: N H LB I/W HO Workshop Report. No. 95-3659. National Institutes of Health. Jeneva; 1995: 1-176.
7. Bateman E. Simplifying asthma treatment. Berlin; 1999.
8. Chung K.F. Management of difficult asthma. Br. J. Hosp. Med. 1994; 51: 80-81.
9. Огородова Jl.M., Кобякова О.С., Фрейдин М.Б. и др. Роль интерлейкина-5 в патогенезе бронхиальной астмы. Аллергология 1999; 4: 32-36.
10. Warner I.O., Pohunek P., Marguet С. et al. Epidemiology and genetics of asthma. J. Allergy Clin. Immunol. 2000; 105 (2): 1-17.
11. Barnes P.J. Difficult asthma. Eur. Respir. J. 1998; 12 (5): 1209-1218.
12. Jenkins C., Woolcock A.J., Saarelainen P. et al. SeretideTM (salmeterol 50 meg/fluticasone propionate 250mcg bid) compared with budesonide (800 meg) bid. Respir. Med. 2000; 94 (7): 715-723.
13. Kavuru М., Melamed J., Gross G. et al. Salmeterol and fluticasone propionate combined in a new powder inhalation device for the treatment of asthma: a randomised, double blind placebo controlled trial. J. Allergy Clin. Immunol. 2000; 105: 1108-1116.
Review
For citations:
Ogorodova L.M., Kobyakova O.S., Petrovsky F.I., Abazova F.l., Petrovskaya Yu.A., Salnikov A.V. Some aspects of therapyresistance in patients with, atopic moderate-to-severe asthma. PULMONOLOGIYA. 2001;(2):69-74. (In Russ.)
Views:
162
Email this article 