On the theophylline titration day, serum theophylline levels ranged from 10.2 to 18.2 mg/ml, with a mean of 13.3 ±: 2.1 mg/ml. These levels were produced by doses ranging from 270 to 697 mg (3.5 to 10.4 mg/kg). When these doses were repeated during the experiment, the mean blood level was almost identical, 13.3 ± 3.3 mg/ml. The lower theophylline dose, 130 mg, was administered on three testing days (on two of these days with
As bronchodilators, theophylline and ^-adrenergic agonists appear to have partially additive effects. Pulmonary function improves to a greater extent when the two drugs are given together than when the same doses are given separately. In vivo effects are not synergistic, as might be predicted from in vitro studies demonstrating that both agents act to increase intracellular cyclic AMP, and that their effects on both cyclic AMP and cellular function are synergistic. In addition to their
No differences were observed between groups receiving active vaccine and placebo in the mean PEF in the morning, noon, or evening during the first seven days after vaccination (Fig 1). Symptom scores for dyspnea, cough, and production of sputum and also the need for medication were similar in the two groups. Age, sex, duration of the disease, hypersensitivity to aspirin , atopic status, history of attacks of asthma induced by viral infections, diurnal variation of baseline PEF of
Acute respiratory viral infection is a frequent cause of exacerbations of asthma in asthmatic patients. Furthermore, viral infections have been shown to increase bronchial sensitivity to inhaled methacholine, carbachol (carbocholine), and histamine. This change may be due partly to epithelial airway damage which exposes the airway receptors to inhaled irritants. Viral infections may also reduce β-adrenergic responsiveness and so enhance bronchial hyperreactivity. Although conclusive evidence of benefit has not been presented, it has been recommended
Clinical characteristics of the three subject groups are shown in Table 1. Sputum eosinophils were insignificantly increased in patients with CVA compared with those with NAC (p = 0.076). Log Dmin was significantly lower in the CVA group than in the NAC group (0.23 ± 0.73 U vs 1.40 ± 0.49 U, p < 0.0001). Log C5 was not significantly different between 11 patients with CVA and 9 patients with NAC (GERD, n = 3;
Airway wall thickening has been observed in postmortem studies of patients with status asthmaticus. The wall thickening is accompanied by airway structural changes, such as subbasement membrane thickening, mucous gland and goblet-cell hyperplasia, increased vascularity, and smooth-muscle hypertrophy and hyperplasia, as well as with chronic inflammation such as mucosal edema and inflammatory cell infiltration. These changes have been further confirmed by studies using bronchial biopsy in living patients. With the advent of high-resolution CT, noninvasive
In this study, we have shown elevation of cys-LTs in EBC in a group of patients with stable asthma receiving inhaled corticosteroids. The increased levels of cys-LTs may indicate the presence of continuing inflammation in the airways despite treatment with inhaled corticosteroids . MacFarlane et al found a strong correlation between increased cys-LTs and eosinophilia in induced sputum. Elevated levels of cys-LT in EBC have been also found in adults and children with mild-to-moderate asthma treated with inhaled corticosteroids.
Exhaled Cys-LTs At the initial visit, Cys-LTs were detected in 25 of 50 patients (14.6 ± 3.3 pg/mL; Fig 1, left, a). However, in all our normal subjects, the levels were undetectable. After treatment with montelukast, cys-LT levels fell to 8.5 ± 2.6 pg/mL after 2 weeks (p > 0.05) and to 3.9 ± 1.3 pg/mL after 4 weeks (p < 0.01). When we included into analysis only patients with detectable cys-LTs at the initial visit, the reduction in
All patients were recruited from asthma clinics in a primary care practice (Table 1). Accurately interpreted spirometry in primary care at asthma and COPD in clinics – https://onlineasthmainhalers.com/spirometry-can-be-done-in-family-physicians-offices-and-alters-clinical-decisions-in-management-of-asthma-and-copd.html . Patients had been receiving a stable dose of inhaled steroids for at least 2 months. All patients used short-acting P-agonists as needed, and 26 of 50 patients were also receiving a long-acting p2-agonist. After an initial visit and baseline measurements, all patients received 4 weeks of treatment
Asthma is a chronic inflammatory disease of the airways characterized by an infiltration of the airways by inflammatory cells including eosinophils , mast cells, and T lymphocytes. Inhaled corticosteroids remain a first-line therapy for the control of inflammation in patients with asthma. However, it appears that suppression of inflammation may not be complete, and the effect of inhaled corticosteroids on cysteinyl-leukotriene (cys-LT) biosynthesis is lim-ited. cys-LTs are important inflammatory mediators of asthma produced by the 5-lipoxygenase
