BUDESONIDE AFFECTS ALLERGIC MUCOCILIARY DYSFUNCTION

Airway inflammation characterized by neutrophils and free elastase con tributes to allergic mucociliary dysfunction. Glucocorticosteroids are the most important anti-inflammatory agents used in the treatment of asthma, but their effect on allergic mucociliary dysfunction is not kn own. Therefore, we assessed both the prophylactic and therapeutic effe cts of the glucocorticosteroid budesonide on antigen-induced mucocilia ry dysfunction in sheep. Tracheal mucus velocity (TMV), a marker of mu cociliary clearance, was measured by using a roentgenographic techniqu e. When budesonide was administered either 30 min before or 1 h after airway challenge with Ascaris suum, the antigen-induced fall in TMV at 6 h was prevented. The effects on TMV at 8 and 24 h after challenge w ere also determined when budesonide and, for comparative purposes, alp ha(1)-protease inhibitor were given 6 h after antigen challenge. Budes onide treatment improved TMV at 8 h, but TMV was not significantly dif ferent from antigen alone at 24 h. Treatment with alpha(1)-protease in hibitor, however, caused only a significant reversal of the antigen-in duced fall in TMV at 24 h after challenge; this indicates a more prolo nged effect than budesonide. Our results suggest that antiproteases ma y have a potential role as a therapeutic approach to mucociliary dysfu nction in asthma and provide evidence for another means by which gluco corticosteroids contribute to the control of the disease.