Effect of inhaled corticosteroids on systemic inflammation in asthma

Ramaraju, Karthikeyan; Krishnamoorthy, S.; Maamidi, Smrithi; Kaza, Anupama Murthy; Balasubramanian, Nithilavalli

doi:10.4103/2229-3485.128026

Cited by 10 publications

(3 citation statements)

References 17 publications

(20 reference statements)

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“…Previous studies have demonstrated that treatment of asthma with anti-inflammatory medications such as inhaled corticosteroids results in lower levels of markers of systemic inflammation. 25, 26 The identification of elevated inflammatory markers among participants with persistent asthma in our study is hypothesis-generating; however, we note that their addition to the models did not attenuate the relationship between persistent asthma and CVD events, so we cannot imply a mediated effect. This may be due to partial treatment of inflammation by controller medications.…”

Section: Discussionmentioning

confidence: 65%

Asthma Predicts Cardiovascular Disease Events

Tattersall

Guo

Korcarz

et al. 2015

ATVB

129

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Objectives To identify and characterize an association between persistent asthma and cardiovascular disease (CVD) risk in the Multi-Ethnic Study of Atherosclerosis (MESA). Approach and Results MESA is a longitudinal prospective study of an ethnically diverse cohort of individuals free of known CVD at its inception. Presence and severity of asthma were assessed in the MESA at Exam 1. Persistent asthma was defined as asthmatics using controller medications (inhaled corticosteroids, leukotriene inhibitors, oral corticosteroids) and intermittent asthma as asthmatics not using controller medications. Participants were followed for a mean (standard deviation) 9.1 (2.8) years for development of incident CVD (coronary death, myocardial infarction, angina, stroke, and CVD death). Multivariable Cox regression models were used to assess associations of asthma and CVD. The 6,792 participants were 62.2 (standard deviation 10.2) years old: 47% male (28% African-American, 22% Hispanic, 12% Chinese). Persistent asthmatics (N=156), compared to intermittent (N=511) and non-asthmatics (N=6125), respectively had higher C-reactive protein (1.2 [1.2] vs 0.9 [1.2] vs 0.6 [1.2] mg/L) and fibrinogen (379 [88] vs 356 [80] vs 345 [73] mg/dL) levels. Persistent asthmatics had the lowest unadjusted CVD-free survival rate of 84.1%, 95% confidence interval (78.9–90.3%) compared with intermittent asthmatics 91.1% (88.5–93.8%) and non-asthmatics 90.2% (89.4–91%). Persistent asthmatics had greater risk of CVD events than non-asthmatics (HR 1.6 [95% 1.01–2.5, p=0.040]), even after adjustment for age, sex, race, CVD risk factors, and anti-hypertensive and lipid medication use. Conclusions In this large multi-ethnic cohort, persistent asthmatics had a higher CVD event rate than non-asthmatics.

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Section: Discussionmentioning

confidence: 65%

Asthma Predicts Cardiovascular Disease Events

Tattersall

Guo

Korcarz

et al. 2015

ATVB

129

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“…Various studies conducted for the hsCRP in steroid naïve patients Vs steroid users resuls and its analysis proved that significant increase in hsCRP levels in steroid naïve patients when compared to control groups 17,18 . Our study showed no significant correlation (p=0.093) of hsCRP in patients using inhaled steroids and patients not using ICS , which is in concordance with earlier authers 13,14 .hsCRP and pulmonary function tests documented by earier authors proved that asthmatic patients with high hs CRP have more severe obstruction with low FEV 1 values and also with high hs CRP levels showed significant increase in respiratory symptoms of wheeze, attacks of breathlessness and nocturnal cough it can be concluded hsCRP as sensitive marker for severe asthma 19 .…”

Section: Discussionmentioning

confidence: 98%

Role of hsCRP as a marker in assessing severity of asthma

Balaji¹,

Mathanraj²,

Praveenraj³

2020

IJIRM

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Asthma is usually characterized by chronic airway inflammation along with respiratory manifestations like, shortness of breath, wheezing, chest tightness and variable expiratory airflow limitation. Studies have indicated increased levels of systemic markers high sensitivity C-reactive protein in patients with bronchial asthma. Assessment of the levels of high sensitivity C-reactive protein in asthmatic patients.It is a comparative-descriptive and observational study, done during the study period April 2014 – June 2015, and the number of asthmatic patients was 80 and 24 healthy controls. High sensitivity C-reactive protein (hsCRP) levels increased in asthmatic patients irrespective of the use of Inhaled corticosteroids. The mean high sensitivity C-reactive protein level of group A (steroid naïve) is 3.9085 which is higher than that of group B (steroid using patients) 2.7575 and healthy controls 0.5138. Although using Inhaled corticosteroids lead to decrease in hsCRP levels, the difference between the means of hsCRP among the two groups A and B was not statistically significant (p=0.093). But when hsCRP levels of group A and group B are compared with the controls, there was high statistical significance (p=0.001). In Pulmonary function test results, the relationship between hsCRP and FEV1 (forced expiratory volume) showed a negative correlation of hs CRP with FEV1%, and it had even more significant negative correlation in patients who are steroid naïve than patients using steroids. Diminished pulmonary function is related with raise serum hsCRP level more in steroid naive patients. Serum hsCRP can be used as one of the indirect parameters for the assessment of degree of severity in the airways manifestation.

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“…A dysregulation of protease activity is present in both IBD[ 27 ] and COPD[ 28 ], and is associated with the breakdown of connective tissue components and the ensuing remodeling process[ 1 , 29 ]. Alterations in immune cell homing function[ 1 , 22 ] may explain the low grade chronic systemic inflammation that is present in IBD[ 30 ], COPD[ 31 ], asthma[ 32 - 34 ] and bronchiectasis[ 35 - 38 ]. The hygiene hypothesis, proposing that a lack of exposure to microorganisms during childhood contributes to abnormal immune reactions later in life, may also constitute a common factor linking asthma, IBD and a variety of other conditions[ 39 ].…”

Section: Similarities In Pathogenesis and Risk Factorsmentioning

confidence: 99%

Inflammatory bowel disease and airway diseases

Vutcovici¹,

Brassard²,

Bitton³

2016

WJG

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Airway diseases are the most commonly described lung manifestations of inflammatory bowel disease (IBD). However, the similarities in disease pathogenesis and the sharing of important environmental risk factors and genetic susceptibility suggest that there is a complex interplay between IBD and airway diseases. Recent evidence of IBD occurrence among patients with airway diseases and the higher than estimated prevalence of subclinical airway injuries among IBD patients support the hypothesis of a two-way association. Future research efforts should be directed toward further exploration of this association, as airway diseases are highly prevalent conditions with a substantial public health impact.

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Effect of inhaled corticosteroids on systemic inflammation in asthma

Cited by 10 publications

References 17 publications

Asthma Predicts Cardiovascular Disease Events

Asthma Predicts Cardiovascular Disease Events

Role of hsCRP as a marker in assessing severity of asthma

Inflammatory bowel disease and airway diseases

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