Pulmonary Diseases and Corticosteroids

Abstract

Steroids (corticosteroids) are anti-inflammatory drugs. Corticosteroids are used in many pulmonary conditions. Corticosteroids have a proven beneficial role in asthma, croup (Laryngotracheobronchitis), decreasing the risk and severity of respiratory distress syndrome (RDS), allergic bronchopulmonary aspergillosis, interstitial lung disease, hemangioma of trachea, Pulmonary eosinophillic disorders. Role of corticosteroids is controversial in many conditions e.g. idiopathic pulmonary hemosiderosis, bronchiolitis, hypersensitivity pneumonitis, hyperplasia of thymus, bronchiolitis, acute respiratory distress syndrome, aspiration syndromes, atypical pneumonias, laryngeal diphtheria, AIDS, SARS, sarcoidosis, meconium aspiration syndrome (MAS), pulmonary haemorrhage, bronchitis, bronchiolitis obliterans with organizing pneumonia in JRA, histiocytosis, alpha-1 antitrypsin deficiency, bordtella pertusis, pulmonary involvement in histiocytosis. However these are used empirically in many of these conditions despite lack of clear evidence in favour. There is concern about their side effects, especially on growth. Systemic steroids are associated with significant adverse effects. Pulmonary conditions have a strategic advantage that inhaled corticosteroids are useful in many of these. Although inhaled preparations of corticosteroids have been developed to maximise effective treatment of lung diseases characterised by inflammation and reduce the frequency of harmful effects, these have not been eliminated. There are situations where only systemic steroids are useful. Clinicians must weigh the benefits against the potential detrimental effects. It is recommended that standard protocols for use of steroids available in literature should be followed, always keeping a watch on the potential hazards of prolonged use.

Hemoptysis in patients of celiac disease with disproportionately severe anemia: tip of the iceberg?

“…The largest series of patients in literature showing response in IPH with GFD has been reported by Khemiri et al and Sethi et al [7,13]. Khemiri et al reported clinical and radiological improvement in both pulmonary and gastrointestinal symptoms with corticosteroid treatment combined with a gluten-free diet.…”

“…Pacheco et al reported that GFD induced remission in IPH can be on long-term basis up to 4 years [16]. Sethi et al reported a patient who was initially followed up as IPH [7]. The pulmonary symptoms persisted despite steroids and azathioprine over a follow up period of two and half year.…”

Yoga Training Improves Quality of Life in Women with Asthma

“…4 Current therapies include anti-inflammatory drugs and bronchodilators, but unfortunately these therapies are often associated with many side-effects. 5 Thus, a possible role for alternative therapies aimed at controlling the asthmatic condition and improving quality of life has emerged.…”

An Inflamed Human Alveolar Model for Testing the Efficiency of Anti-inflammatory Drugs in vitro

“…Clinically, immunosuppressant drugs, such as corticosteroids, among them methylprednisolone (MP), play an integral role in anti-inflammatory treatments of pulmonary diseases, particularly in asthma, acute lung injury, and acute respiratory distress syndrome (Silva et al, 2009;Barnes, 2011;Marik et al, 2011;Liu et al, 2013). The efficacy of corticosteroids in suppressing lung inflammation has been confirmed by both systemic administration and inhalation (Sethi and Singhal, 2008;Higham et al, 2015). MP has been shown to attenuate acute lung injury, induced with bacterial endotoxin lipopolysaccharide (LPS), via promoting macrophage polarization into the M2 subset (Tu et al, 2017).…”