Corticosteroid therapy for acute asthma

Rowe, Brian H.; Edmonds, Marcia L.; Spooner, Carol; Diner, Barry; Camargo, Carlos A.

doi:10.1016/j.rmed.2003.11.016

Cited by 83 publications

(55 citation statements)

References 32 publications

(33 reference statements)

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“…Despite intensive studies on pathogenesis as well as therapy, asthma remains an increasingly prevalent disease of the industrialized nations (1,2). Yet, current asthma therapies are not cures, and only pharmacological control of asthmatic symptoms is being achieved in most asthmatics with antiinflammatory agents (37) and/or long-acting bronchodilators (1,38). Therefore, there is the obvious need for a new therapy for severe asthma, and the use of EM-X as a TH2-suppressing reagent for immunotherapy in allergic diseases is likely to have great potential.…”

Section: Discussionmentioning

confidence: 99%

Effective microorganism fermentation extract (EM-X) attenuates airway hyperreactivity and inflammation through selective inhibition of the TH2 response independently of antioxidant activity

Seo²,

Hwang³

et al. 2007

Int J Mol Med

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Abstract. The effective microorganism fermentation extract (EM-X) is an antioxidant cocktail derived from the fermentation of plant material with effective microorganisms, and its clinical application is being increasingly scrutinized. In the current study, the antiasthmatic effect of EM-X was investigated using a mouse model. Inhalation of EM-X during OVA challenge resulted in a significant reduction in airway hyperreactivity (AHR) and airway recruitment of leukocytes including eosinophils. However, the level of 8-isoprostane in bronchoalveolar lavage fluid (BALF), a marker of oxidative stress in asthmatic patients, was unaltered by EM-X inhalation. Instead, ELISA data showed that levels of IL-4, IL-5 and IL-13 in BALF or lung tissues were significantly lower in EM-X-inhaling mice than in the control mice, but not the IFN-γ level. A considerably lower amount of Ag-specific IgE and IgG1 was detected in the serum of EM-X-inhaling mice than in the serum of the controls, whereas their IgG2a secretion was similar. In addition, Ag-specific ex vivo IL-4, IL-5 and IL-13 production of draining lymph node cells was markedly diminished by EM-X inhalation, but not IFN-γ. These data clearly show that inhaled EM-X suppresses type 2 helper T (TH2), but not type 1 helper T (TH1), response. In conclusion, inhalation of EM-X attenuates AHR and airway inflammation which results from selective inhibition of the TH2 response to allergen, but independently of antioxidant activity. Our data also suggest that EM-X may be effectively applied for control of allergic asthma.

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Section: Discussionmentioning

confidence: 99%

Effective microorganism fermentation extract (EM-X) attenuates airway hyperreactivity and inflammation through selective inhibition of the TH2 response independently of antioxidant activity

Seo²,

Hwang³

et al. 2007

Int J Mol Med

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“…These medications speed the resolution of airflow obstruction and reduce the rate of relapse and reduce hospitalizations. 14,15 Oral prednisolone has effects equivalent to those of intravenous methyl prednisolone and is usually preferred as the administration is easier. 16,17 There is no consensus on the dose and dosing schedule of inhaled budesonide in exacerbations of asthma.…”

Section: Discussionmentioning

confidence: 99%

To evaluate the efficacy of nebulized budesonide compared to oral prednisolone in the management of moderate exacerbation of acute asthma

Sharma

Harish

Dutt

et al. 2017

Int J Contemp Pediatr

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Background: Corticosteroids are extremely effective drugs and are used extensively in the management of asthma. Inhaled corticosteroids may offer some benefit in patients with mild to moderate obstruction in acute exacerbation and also offer the advantage of administration directly to the lungs. Hence this study was done to evaluate the efficacy of nebulized budesonide as compared to oral prednisolone in the management of moderate exacerbation of acute asthma.Methods: A total of 80 children attending pediatric emergency of SMGS Hospital Jammu aged 1 to 18 years with a moderate exacerbation of asthma despite three salbutamol nebulizations were enrolled and randomized into two groups. First group recieved nebulized budesonide (800 mcg) at hourly intervals for three doses followed by twice a day (n=37) while second group recieved oral prednisolone 2 mg/kg/day in two divided doses (n=43). Both groups continued to receive oxygen inhalation and nebulized salbutamol (0.15 mg/kg/dose) initially at hourly intervals for 3 doses followed by 6 hourly. The pattern of response as observed by the pulmonary scores in the two groups was compared.Results: The pulmonary scores were significantly improved at 1, 2 and 6 hours after starting treatment in the budesonide group as compared to prednisolone group (p < 0.01) although the difference was not significant after 12 hours. Oxygen saturation also showed a significant early improvement.Conclusions: This early demonstrable significant improvement in the clinical parameters of the inhaled budesonide group apparently suggests that inhaled budesonide may be efficacious in treating moderate exacerbations of asthma.

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“…In particular, there is the obvious need for new therapy for severe asthma that is poorly controlled by high doses of corticosteroids (38), as well as agents to counter acute emergency asthma. A long-term goal is to develop disease-modifying immunotherapy, that could be introduced in childhood to alter the natural history of asthma (4).…”

Section: B a C Bmentioning

confidence: 99%

Effective Microorgainsm (EM) Fermentation Extract Attenuates Airway Hyperreactivity and Lung Inflammation In A Mouse Model of Asthma

Choi

Seo

et al. 2006

J Bacteriol Virol

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Effective microorganism (EM) fermentation extract has been widely used for agricultural and environmental application. It has been recently revealed that EM cocktail treatment may be effective for treatment of diseases including cancer. In the present study, effectiveness of EM cocktail to control asthma was investigated using a mouse model of allergic asthma. Asthmatic mice sensitized and intranasally challenged with OVA were orally given EM fermentate (EM-1 ® ) during antigen challenge. Administration of EM-1 ® resulted in a significant reduction in airway hyper-reactivity (AHR) and airway recruitment of total leukocytes and eosinophils. Cytokine (IL-4, IL-5 and IFNγ) levels in bronchoalveolar lavage fluid (BALF) and lung tissues were not altered by EM-1 ® treatment. However, IL-13 level in BALF was considerably lower in EM-1 ® treated mice than in controls. Moreover, Ag-specific IL-4, IL-5 and IL-13 production of draining lymph node cells were markedly downregulated by EM-1 ® treatment when compared to controls, whereas their IFNγ production was not significantly different. Those data show that EM-1 ® treatment suppresses type 2 helper T (Th2), but not type 1 helper T (Th1), cell response. This finding was also supported by serum antibody data showing that IgE and IgG1 levels in EM-1 ® treated mice were significantly lower than in controls, while IgG2a level was not significantly different between two groups. In conclusion, oral administration of EM-1 ® attenuates asthmatic manifestations including AHR and airway recruitment of eosinophils in a mouse model and which possibly results from selective inhibition of Th2 cell response to allergen. Our data also suggest that EM-1 ® may be effectively applied for control of allergic asthma.

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Corticosteroid therapy for acute asthma

Cited by 83 publications

References 32 publications

Effective microorganism fermentation extract (EM-X) attenuates airway hyperreactivity and inflammation through selective inhibition of the TH2 response independently of antioxidant activity

Effective microorganism fermentation extract (EM-X) attenuates airway hyperreactivity and inflammation through selective inhibition of the TH2 response independently of antioxidant activity

To evaluate the efficacy of nebulized budesonide compared to oral prednisolone in the management of moderate exacerbation of acute asthma

Effective Microorgainsm (EM) Fermentation Extract Attenuates Airway Hyperreactivity and Lung Inflammation In A Mouse Model of Asthma

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