EFFECTS OF LONG-TERM GLUCOCORTICOID THERAPY ON BRONCHOALVEOLAR CELLS IN ADULT PATIENTS WITH BRONCHIAL-ASTHMA

The effects of long-term glucocorticoid therapy on airway inflammation were examined in 84 asthma patients. The proportion of lymphocytes in bronchoalveolar lavage (BAL) fluid was significantly decreased in pat ients with steroid-dependent intractable asthma (SDIA) compared to res ults in non-SDIA patients, while BAL neutrophils were significantly in creased in SDIA patients compared to results in non-SDIA patients. Reg arding age, in patients under the age of 69 (except those between 30 a nd 39), BAL lymphocyte number was significantly decreased in SDIA comp ared with non-SDIA subjects, and in patients between 50 and 69, BAL ne utrophils were significantly increased in SDIA compared with non-SDIA subjects. The number of BAL lymphocytes was significantly lower in pat ients with serum cortisol levels of less than 5.0 mug/dl than in those with levels of more than 5.1 mug/dl. BAL lymphocyte number was also s ignificantly lower in patients who had received glucocorticoid therapy for more than 6 years than in those who had received such therapy for 2 years. These results show that long-term glucocorticoid therapy dec reases the number of lymphocytes and increases neutrophil numbers in t he airways.