Original Articles: Allergy, Rhinitis, Other Respiratory Diseases
Effects of prednisone on the cellular responses and release of cytokines and mediators after segmental allergen challenge of asthmatic subjects

https://doi.org/10.1067/mai.2001.116004Get rights and content

Abstract

Background: Systemic glucocorticoids are a major therapy for the management of allergic inflammation and asthma; however, information about their effects in vivo are limited. Objective: This study was performed to examine the effects of prednisone on inflammatory mediators, cytokines, and cellular responses in the model of segmental allergen challenge (SAC) of allergic asthmatic subjects. Methods: The effects of a 3-day pretreatment with oral prednisone (30 mg twice daily) on the physiologic and inflammatory responses to SAC were studied in 10 allergic asthmatic subjects in a double-blind, placebo-controlled, crossover protocol. Results: Prednisone improved baseline FEV1 by 10% and modestly inhibited the SAC-induced fall in FEV1 at 30 minutes and at 6 to 8 hours. Five minutes after challenge, levels of histamine, PGD2, 9α,11β-PGF2, and thromboxane B2 increased in bronchoalveolar lavage fluid (median increase, 5- to 14-fold); prednisone did not inhibit these responses. Prednisone inhibited (median decrease, 66%-97%) the total influx of inflammatory cells, specifically eosinophils, basophils, and some subsets of T lymphocytes (CD4, CD45RA, and CD45RO cells) assessed 19 hours after SAC, but it did not inhibit the influx of neutrophils. Increases in soluble E-selectin, kinins, and albumin were also inhibited by the glucocorticoid (median decrease, 36%-74%). Prednisone treatment inhibited the appearance of mRNA, protein, or both for TH2 cytokines (IL-4 and IL-5), as well as for IL-2 and transforming growth factor α, but did not inhibit increases of immunoreactive GM-CSF in bronchoalveolar lavage fluid. Conclusion: These studies indicate that prednisone suppresses multiple components of allergic airway inflammation, including cell recruitment, adhesion molecule expression or release, airway permeability, and production of cytokines potentially involved in airway immunity or remodeling. (J Allergy Clin Immunol 2001;108:29-38.)

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    Intercalation increased the thermal stability of the drug by ca. 100 °C and the antioxidant ability of the intercalated species, as studied by UV–vis spectroscopy, was similar to that shown by the pure drug. Prednisone (PNS) is a steroidal antiinflammatory drug, but it is scarcely soluble in water, and so it is poorly dispersed in physiological fluids, leading to problems in efficient delivery; encapsulation in micelles, microspheres or microemulsions has been tested as alternative routes to overcome these problems (Brown et al., 2007; Karpela et al., 2007; Liu et al., 2001). F. Li et al. (2009) and Y. Li et al. (2009a) have carried out a study on the encapsulation of prednisone in micelles and their intercalation in Mg,Al LDHs as an alternative delivery route using two different encapsulating agents.

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Supported by National Institute of Health grants P01 HL 49545, U19 AI31867, R01 AI31891, and AI44885.

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