EFFECT OF LOW-DOSE BECLOMETHASONE DIPROPIONATE ON ASTHMA CONTROL AND AIRWAY INFLAMMATION

The effects of usual or low doses of inhaled corticosteroids on airway mucosal inflammation have not yet been examined. We therefore, compar ed the effects of inhaled beclomethasone dipropionate (BDP) 336 mu g.d ay(-1) on asthma control outcomes and markers of airway inflammation. Twenty-four adult subjects with mild and moderate asthma were randomiz ed to receive either BDP or placebo for four weeks; then subjects ente red a single blind four week placebo run-in period. We found that the BDP group had significantly greater improvements in forced expiratory volume in one second (FEV1), morning peak how and rescue salbutamol us e than the placebo-treated group. The improvement in FEV1 largely reve rsed one meek after treatment was stopped. The decrease in the median percentage of eosinophils in induced sputum in the BDP group from 3.8% to 3.4% was not significant, but because eosinophils increased from 8 .4% to 12.7% in the placebo group, there was a significant difference between treatment groups (p=0.03). There was no significant difference between groups during treatment in the levels of eosinophil cationic protein (ECP), tryptase mucin-like glycoprotein, or fibrinogen in indu ced sputum. The change in FEV1 in the EDP group did not correlate sign ificantly with the change in eosinophil percentage or ECP levels. We c oncluded that four weeks of treatment with inhaled beclomethasone dipr opionate 336 mu g.day(-1) was associated with significant improvements in peak how forced expiratory volume in one second, and rescue salbut amol use in asthmatic subjects but was not associated with large reduc tions in markers of eosinophilic inflammation, bronchovascular permeab ility, or mucus hypersecretion.