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Inhaled Corticosteroid Treatment for Asthma

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Increased numbers of goblet cells associated with decrease in the ciliated epithelium occur at an early stage in the patient with asthma. Recent bronchial biopsy studies have demonstrated that these changes may occur even in the mildest asthmatic patient. The protective function of the epithelium is thus compromised and secretion enhanced in early asthma. Anti-inflammatory therapy should be employed at an early stage in the asthmatic patient. Avoidance of allergen is also essential if the source of the inflammation is atopic disease. Inhaled corticosteroids not only reduce bronchial hyperresponsitivity, but also improve the diurnal variation that occurs in lung function in the asthmatic patient. Inhaled corticosteroid therapy is associated with the normalization of the ciliated to goblet cell ratio and a reduction in the inflammatory cell infiltrate, including most notably a reduction in eosinophil within the lamina propria and respiratory epithelium. These changes induced by inhaled corticosteroids are not noted when inhaled 2-agonists are employed alone as therapy for asthma. The use of inhaled corticosteroids may thus potentially reverse the pathologic changes that occur even in the early asthmatic patient, whereas utilization of inhaled 2-agonists failed to improve histologic abnormalities that occur in early asthma.
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Document Type: Research Article

Publication date: 1995-03-01

More about this publication?
  • Allergy and Asthma Proceedings is a peer reviewed publication dedicated to distributing timely scientific research regarding advancements in the knowledge and practice of allergy, asthma and immunology. Its primary readership consists of allergists and pulmonologists.

    The goal of the Proceedings is to publish articles with a predominantly clinical focus which directly impact quality of care for patients with allergic disease and asthma.

    Featured topics include asthma, rhinitis, sinusitis, food allergies, allergic skin diseases, diagnostic techniques, allergens, and treatment modalities. Published material includes peer-reviewed original research, clinical trials and review articles.

    Articles marked "F" offer free full text for personal noncommercial use only.

    The journal is indexed in Thomson Reuters Web of Science and Science Citation Index Expanded, plus the National Library of Medicine's PubMed service.
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