Effect of prolonged use of inhaled steroids on the cellular immunity of children with asthma

Levy, Jacov; Zalkinder, Irina; Kuperman, O; Skibin, A.; Apte, Ron N.; Bearman, Jacob E.; Mielke, Paul W.; Tal, Asher

doi:10.1016/s0091-6749(95)70122-2

Cited by 26 publications

(17 citation statements)

References 29 publications

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“…However, in accordance with European guidelines on the treatment of asthma, it is advisable to minimize the long-term use of systemic GC as much as clinically possible. Our data as well as recently published work (44) suggest that inhaled GC do not alter immune functions.…”

Section: Discussionsupporting

confidence: 89%

Suppression of the immune system by oral glucocorticoid therapy in bronchial asthma

Oehling

Akdiş

Schapowal

et al. 1997

Allergy

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The effect of systemic glucocorticoid therapy on immune parameters was studied in patients with bronchial asthma. Patients were divided into two groups: 1) those receiving oral glucocorticoid; 2) control patients who did not receive systemic glucocorticoid treatment. The glucocorticoid dose varied between 5 and 70 mg per day. Patients had been taking oral therapy for at least 1 year. Glucocorticoid treatment was associated with an increased frequency of respiratory tract infections. Therefore, we need to define immune parameters which may predict an increased risk of infections. In this study, we analyzed several surface markers on lymphocytes and monocytes by flow cytometry. A significant reduction of the ratio of peripheral blood CD4+ to CD8+ T cells was associated with the administration of oral glucocorticoids. Furthermore, the expression of the HLA-DR molecule on monocytes was reduced in patients with systemic glucocorticoid therapy compared to control patients. Moreover, the capacity to elaborate cytokines by peripheral blood mononuclear cells upon stimulation was greatly reduced after exposure to glucocorticoids in vivo and in vitro. In addition, the humoral immune response was affected, because reduced IgG, IgM, and IgA levels were observed in patients receiving oral glucocorticoids. These results indicate that systemic glucocorticoid treatment in patients with bronchial asthma is associated with cellular and humoral immunosuppression which results in an increased risk of bacterial and viral infections.

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Section: Discussionsupporting

confidence: 89%

Suppression of the immune system by oral glucocorticoid therapy in bronchial asthma

Oehling

Akdiş

Schapowal

et al. 1997

Allergy

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“…Firstly, this study may indicate that treatment with FP 100 pg bd has a local rather than a systemic effect on the inflammatory process. Comparable to our findings, Levy et al found that parameters of cellular immunity in children with asthma did not change during prolonged daily use of 600 pg inhaled beclomethasone dipropionate (24). Secondly, it is possible that changes in the inflammatory process are not well reflected in peripheral blood.…”

Section: Discussioncontrasting

confidence: 52%

Eosinophil and mast cell parameters in children with stable moderate asthma

Hoekstra

Grol

Hovenga

et al. 1998

Pediatric Allergy Immunology

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“…BUD at high doses (1600 μg) caused a reduction of hypodense eosinophils in peripheral blood ( 213). Finally, in a recent study on children, BDP (600 μg/day or more) did not affect cellular immunity parameters (T and B cells and IL‐2 secretion) and did not increase the risk of infections ( 214).…”

Section: Other Systemic Side‐effectsmentioning

confidence: 85%