Evaluation of bone metabolism after the use of an inhaled glucocorticoid (flunisolide) in patients with moderate asthma

Hauache, Omar M.; Amarante, E. C. J.; Vieira, José Gilberto H.; Faresin, Sônia Maria; Fernandes, Ana Luísa Godoy; Jardim, José Roberto; Lazaretti-Castro, Marise

doi:10.1046/j.1365-2265.1999.00658.x

Cited by 8 publications

(3 citation statements)

References 14 publications

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“…This would account for the reduced wall thickness characteristic of glucocorticoid‐induced osteoporosis. The inhibition of increase in OC mRNA seen in young donor hOBs is in agreement with the known reduction in plasma OC in patients treated with glucocorticoids [Hauache et al, 1999].…”

Section: Discussionsupporting

confidence: 85%

Hydrocortisone increases the rate of differentiation of cultured human osteoblasts

Ireland

Bord

Beavan

et al. 2003

J of Cellular Biochemistry

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Reduced bone formation is the main finding in glucocorticoid-induced osteoporosis. The aim of this study was to determine whether differentiation of cultured human osteoblasts is inhibited by high concentrations of hydrocortisone. We measured the levels of mRNAs for three markers of cellular differentiation, type 1 collagen (COL1), alkaline phosphatase (ALP), and osteocalcin (OC), in four lines of human osteoblasts from female donors cultured with doses of hydrocortisone from 0 microM to 4 microM. The change in ALP/COL1 mRNA ratio over a given time was used to determine the average rate of differentiation of the cells in a culture. Although basal expression profiles and their changes with time were different for the different cell lines, all cell lines showed a dose-dependent rise in the rate of increase of ALP mRNA relative to COL1 mRNA. However, increase in OC mRNA with time, seen here only in young donor hOBs, was significantly inhibited by 4 microM hydrocortisone, indicating that hydrocortisone can inhibit OC expression while promoting cellular differentiation. The data suggest that increasing concentrations of glucocorticoid, including concentrations similar to plasma levels in patients receiving oral glucocorticoid therapy, increase the rate of cellular differentiation.

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Section: Discussionsupporting

confidence: 85%

Hydrocortisone increases the rate of differentiation of cultured human osteoblasts

Ireland

Bord

Beavan

et al. 2003

J of Cellular Biochemistry

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“…The absence of a compensatory PTH response to the lower calcium levels in the glucocorticoidtreated patients may have some role in the bone loss associated with glucocorticoid therapy, as PTH is reported to exert a potent anabolic effect on trabecular bone (Dempster et al, 1993). Hauache et al (1999) reported a trend for a decrease in PTH in patients with moderate asthma treated with inhaled glucocorticoid for 10 weeks. Manelli et al (2001) reported a decreased PTH basal secretion rate in patients chronically treated with glucocorticoids although the fractional pulsatile PTH secretion was increased.…”

Section: Discussionmentioning

confidence: 99%

The impact of different glucocorticoid replacement schedules on bone turnover and insulin sensitivity in patients with adrenal insufficiency

Suliman

Freaney

Smith

et al. 2003

Clinical Endocrinology

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These data indicate that all three replacement schedules were associated with low serum ionized calcium levels without evidence of a compensatory increase in PTH levels. These findings are consistent with direct or indirect suppression of the bone remodelling cycle and suppression of PTH levels. Bone turnover in patients with adrenal insufficiency treated with schedule 3, dexamethasone, was associated with lower bone turnover than patients treated with hydrocortisone schedules 1 or 2. While indices of insulin sensitivity measured during schedules 1, 2 and 3 did not achieve statistical significance, there was an obvious trend for greater insulin resistance to occur with schedules 3 using dexamethasone.

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“…This form of application allows the administration of relatively small doses of the drug, which produce the same beneficial effects in the airways as the systemic use of corticosteroids. 7 Although we have already demonstrated that inhaled flunisolide does not cause alterations in the bone and suprarenal metabolisms of asthmatics, 8 others have demonstrated that a systemic absorption of the inhaled corticosteroid may occur with the subsequent appearance of adverse effects. 9 These effects may be dependent upon the dose, the sensitivity of the organ or of the individual.…”

Section: Introductionmentioning

confidence: 96%

Strength and endurance of the respiratory and handgrip muscles after the use of flunisolide in normal subjects

Jardim

Camelier

Corso

et al. 2007

Respiratory Medicine

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Objective: To evaluate the effects of the inhaled flunisolide upon the strength and endurance of the respiratory and peripheral muscles of normal subjects. Design: A randomized, double blind and placebo-controlled study. Setting: A university-affiliated teaching hospital. Participants: Thirteen normal volunteers selected from a graduation course. Intervention: Subjects were randomly allocated to receive a placebo or corticosteroid (flunisolide) to be inhaled twice a day for 4 weeks. After 2 weeks of a washout period, subjects who were receiving the placebo, received flunisolide and vise versa for another 4-week period. Measurements and results: Spirometry was used to define the volunteers as being normal in terms of pulmonary function. During the study, subjects performed tests of respiratory muscle function (strength and endurance), measurements of handgrip strength and endurance and anthropometric measurements. Muscle strength was measured each week while muscle endurance was measured every 2 weeks. There was no significant difference in the maximal inspiratory and expiratory pressure and handgrip strength during weeks 1-4 when the subjects used either flunisolide or placebo. However, we observed an increase in the endurance time of the respiratory and handgrip muscles in the 4th week of both flunisolide and placebo use, what may be considered due to a learning effect.

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Evaluation of bone metabolism after the use of an inhaled glucocorticoid (flunisolide) in patients with moderate asthma

Cited by 8 publications

References 14 publications

Hydrocortisone increases the rate of differentiation of cultured human osteoblasts

Hydrocortisone increases the rate of differentiation of cultured human osteoblasts

The impact of different glucocorticoid replacement schedules on bone turnover and insulin sensitivity in patients with adrenal insufficiency

Strength and endurance of the respiratory and handgrip muscles after the use of flunisolide in normal subjects

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