Evaluation of Atorvastatin for the Treatment of Patients With Asthma: A Double-Blind Randomized Clinical Trial

Purpose

Statins are known as cholesterol-lowering agents, but have been suggested for the treatment of asthma because of their anti-inflammatory effects. In this study, the potential therapeutic effects of atorvastatin were investigated in asthmatic patients.

Methods

A total of 62 patients with persistent mild to moderate asthma who presented at asthma clinics of Arak University of Medical Sciences were recruited in a double-blind randomized clinical trial. The asthma clinical control score was assessed based on the standardized Asthma Control Test. Lung volume, i.e., percentage of forced expiratory volume in one second (FEV1%) and percentage of forced vital capacity (FVC%), and peripheral blood eosinophils were also measured. The intervention group was treated with atorvastatin 40 mg per day for 8 weeks, while the control group received a placebo. Asthma controller treatments were not changed. At the beginning and end of the study, serum cholesterol and triglyceride levels were measured to evaluate adherence of the patients to the treatment.

Results

The asthma control score did not significantly differ between the intervention and control groups (P=0.06). Difference in FEV1%, FVC%, and blood eosinophil count between the intervention and control groups were not statistically significant (P>0.05). The differences in post-treatment cholesterol and low-density lipoprotein cholesterol levels were significant (P<0.05).

Conclusions

Our study shows that atorvastatin is not effective in the treatment of persistent mild to moderate asthma.     

Immunoregulation of asthma by type 2 cytokine therapies: Treatments for all ages?

Asthma is classically considered to be a disease of type 2 immune dysfunction, since many patients exhibit the consequences of excess secretion of cytokines such as IL-4, IL-5, and IL-13 concomitant with inflammation typified by eosinophils. Mouse and human disease models have determined that many of the canonical pathophysiologic features of asthma may be caused by these disordered type 2 immune pathways. As such considerable efforts have been made to develop specific drugs targeting key cytokines. There are currently available multiple biologic agents that successfully reduce the functions of IL-4, IL-5, and IL-13 in patients, and many improve the course of severe asthma. However, none are curative and do not always minimize the key features of disease, such as airway hyperresponsiveness. Here, we review the current therapeutic landscape targeting type 2 immune cytokines and discuss evidence of efficacy and limitations of their use in adults and children with asthma.     

哮喘患者白细胞介素—10水平变化的探讨

对３２例哮喘性哮喘患者２０名正常对照者，分别用ＥＬＩＳＡ，ＲＴ－ＰＣＲ，细胞培养技术探讨哮喘患者白细胞介素－１０（ＩＬ－１０）的变化。结果发现，哮喘患者血浆和细胞培养上清液的ＩＬ－１０值比正常对照组明显降低（Ｐ〈０．０１），ＲＴ－ＰＣＲ也显示出正常对照组的扩增条带明显强于哮喘组，本研究说明，哮喘患者外周血淋巴细胞的ＩＬ－１０基因表达和血浆ＩＬ－１０水平均明显减少，可能与哮喘的发生发展有关。     

Prevalence and Risk Factors for Depression in Korean Adult Patients with Asthma: Is There a Difference between Elderly and Non-Elderly Patients?

Depression is an important comorbidity of asthma. However, little information is available about depression and its potential impact on asthma control in Korean adult asthma patients. We aimed to estimate the prevalence and risk factors for depression in Korean adults with persistent asthma. The 127 non-elderly (20-64 yr) and 75 elderly (≥65 yr) patients with asthma were recruited. Demographic and clinical data were extracted, and the patients completed the Asthma Specific Quality of Life (AQOL) questionnaire and asthma control test (ACT). Depression status was defined using the Korean version of the Patient Health Questionnaire-9 (PHQ-9). Depression was more prevalent in non-elderly (18.9%) than in elderly patients with asthma (13.3%). Patients with depression were significantly younger, had lower economic status, shorter disease duration, poorer asthma control, and worse AQOL scores (P<0.05). Within the non-elderly group, younger age and shorter disease duration were significantly associated with depression (P<0.05). Within the elderly group, a higher body mass index and current smoking status were significantly associated with depression (P<0.05). The PHQ-9 score was significantly correlated with worse ACT and AQOL scores in both groups. In conclusion, depression is strongly associated with poor asthma control and quality of life in Korean adult asthma patients. Our results provide important clues that used to target modifiable factors which contribute to development of depression in asthma patients.

Graphical Abstract

相似文献   

Inaccurate perception of asthma symptoms: A cognitive–affective framework and implications for asthma treatment

Inaccurate perception of respiratory symptoms is often found in asthma patients. Typically, patients who inaccurately perceive asthma symptoms are divided into underperceivers and overperceivers. In this paper we point out that this division is problematic. We argue that little evidence exists for a trait-like stability of under- and overperception and that accuracy of respiratory symptom perception is highly variable within persons and strongly influenced by contextual information. Particularly, expectancy and affective cues appear to have a powerful influence on symptom accuracy. Based on these findings and incorporating recent work on associative learning, attention and mental representations in anxiety and symptom perception, we propose a cognitive–affective model of symptom perception in asthma. The model can act as a framework to understand both normal perception as well as under- and overperception of asthma symptoms and can guide the development of affect-related interventions to improve perceptual accuracy, asthma control and quality of life in asthma patients.     

Maternal and neonatal risk factors of asthma in children: Nationwide population based study

BackgroundSmall population group-based cohorts have found that perinatal factors may contribute to the development of asthma in children. We aimed to investigate maternal and neonatal risk factors for the asthma phenotypes using two databases from the Taiwan's Maternal and Child Health Database (TMCHD) and the National Health Insurance Research Database (NHIRD).MethodsPerinatal data was obtained from 2004 to 2008 in the TMCHD and linked the NHIRD to obtain relevant medical information regarding maternal and neonatal risk factors of three asthma phenotypes which were identified as transient early asthma, persistent asthma, and late-onset asthma. A multivariate logistic regression analysis was conducted to adjust for covariates.ResultsThe percentage of non-asthmatic patients was 77.02% and asthmatic (transient early asthma, late onset asthma, and persistent asthma) patients were 8.96%, 11.64%, and 2.42%, respectively. Maternal risk factors—including Cesarean section, maternal asthma, maternal allergic rhinitis (AR), and premature rupture of membranes—and neonatal risk factors, such as male gender, gestational age 29–37 weeks, ventilator use, antibiotics use, AR, and atopic dermatitis, were associated with the development of these three asthma phenotypes. Twins and a gestational age of 28 weeks or less premature were associated with the development of transient early asthma and persistent asthma, but not late onset asthma. Triplets and above were associated with the development of transient early asthma, but not late onset or persistent asthma.ConclusionVarious asthma phenotypes have different risk factors; therefore, their distinct risk factors should be identified in order to early diagnosis and treatment.     

支气管哮喘的免疫治疗研究进展

支气管哮喘是受遗传因素和环境因素双重影响的气道炎症性疾病,是目前危害公共健康的问题之一,在过去的几十年里其发病率呈现上升的趋势。随着对哮喘发病机制的深入研究,辅助性T淋巴细胞亚群功能失调,即Th1Th2细胞失衡,在哮喘发生中的作用已越来越为人们所认识,故针对调节Th1Th2细胞间平衡的哮喘免疫治疗已成为研究热点,抑制Th2细胞免疫或增强Th1细胞免疫的治疗方法取得了一定的进展。     

遗传性支气管哮喘家系过敏原皮试的特点

通过对一常染色体显性遗传的支气管哮喘家系成员１３４例过敏原皮肤试验观察，发现这一家系中，与上代有血缘关系的家系成员中，哮喘患者对几种常见的过敏原的阳性反应率反而低于未发病者的反常现象，并观察到有血缘关系者对过敏原蟑螂阳性反应率显著高于非血缘这有系成员，指出这些观察结果在分析这一家系哮喘遗传和发病方面的意义。     

嗜酸性粒细胞活化趋化因子与支气管哮喘的研究进展

嗜酸性粒细胞活化趋化因子(Eotaxin)是CC趋化因子家族成员之一,由结构性细胞和渗出性炎症细胞产生,是嗜酸性粒细胞、嗜碱性粒细胞和Th2型细胞因子的化学激活趋化剂,通过其受体(CCR3)选择性地诱导嗜酸性粒细胞在肺内黏附、募集和脱颗粒。     

哮喘大鼠血清刺激下内皮细胞表面粘附分子ICAM—1的表达

近十五年人们才发现炎症是哮喘发病的病理基础,它以白细胞浸润为主要特征,过程由白细胞与内皮细胞表面粘附分子介导,ICAM－1就是其中之一,我们在前期活体动物实验中证实了哮喘动物肺组织中内皮细胞一白细胞粘附现象显著,并且肺组织ICAM－1高表达,这有可能是发病过程中ICAM－1大量表达于内皮细胞表面,导致内皮细胞一白细胞粘附增加的结果。本实验采用肺组织机械分离法体外培养大鼠肺内皮细胞,将哮喘病理血清与内皮细胞共同孵育,用于细胞粘附的体外研究,借助间接免疫荧光标记技术及流式细胞分离法,我们首先研究了受哮喘病理血清刺激后肺微血管内皮细胞表面ICAM－1表达的情况,结果发现,血清孵育的内皮细胞ICAM－1表达比用DMEM培养基培养的内皮细胞表达量高;哮喘血清刺激4h后ICAM－1表达量达到峰值,长于4h则很快降低;正常血清或培养基处理的内皮细胞表达持续在一个低水平。