Influence of different dosage schedules of inhaled @entity5023 on peripheral blood cytokine concentrations in childhood XXXX .

@entity748 @entity32 @entity1 @entity225 @entity565 @entity379 @entity3646 @entity688 @entity5023
BACKGROUND: Asthma is characterized by eosinophilic airways @entity32 with elevated levels of @entity3646 , @entity225 and sICAM-1, and reduced levels of @entity688 and @entity379 . Inhaled corticosteroids powerfully reduce airways @entity32 . OBJECTIVE: To investigate if eosinophil counts, serum eosinophilic cationic protein (ECP) and sICAM-1 levels, as well as serum and production of cytokines ( @entity3646 , @entity225 , @entity688 , @entity379 ) by peripheral blood monocytes (PBMCs) are useful markers to monitor therapy with inhaled @entity5023 (FP) in @entity748 @entity1 . METHODS: In a double-blind, 1-year study, 55 @entity748 @entity1 (aged 6-10 years) stopped inhaled corticosteroids for a mean period of 24 days and were randomized to receive either FP 200 microg/day (constant dose group), or a starting dose of FP 1000 microg/day with two monthly reductions to 500, 200 and 100 microg/day (stepdown group). Hyper-responsiveness, symptom scores and blood sampling were performed at 2-month intervals. RESULTS: Symptoms and hyper-responsiveness improved significantly in both treatment groups after reintroduction of FP. Eosinophil counts decreased significantly more during the first 2 months of FP in the stepdown group than in the constant dose group (P = 0.03). We found a trend towards a dose-dependent response in changes of eosinophil counts and serum ECP levels during treatment. Serum @entity3646 and @entity225 levels were undetectable in the majority of @entity1 . No significant effect of the dose of FP on the release of @entity3646 , @entity225 , @entity688 or @entity379 by Con A stimulated PBMCs was found. sICAM-1 levels did not significantly differ at any time point between the two groups. CONCLUSION: Serum ECP as well as peripheral blood eosinophils, cytokine production by PBMCs and sICAM-1 levels are insensitive markers in titrating and monitoring therapy with inhaled corticosteroids over a wide dose range in childhood @entity565 .
