Quantification budesonide on of the effect of inhaled airway inflammation in intermittent asthma by bronchitis index

The bronchitis index (BI) is a scoring system for the visual quantification of airway inflammation by flexible bronchoscopy. A prospective study was c arried out to determine whether patients with intermittent asthma present a considerable visible airway inflammation. Ten steroid-naive patients with intermittent asthma taking only inhaled beta (2)-agonists were enrolled and received budesonide (800 mug/day) over a period of 4 weeks. The airway inf lammation was assessed by flexible electronic videobronchoscopy before and after the steroid treatment phase and quantified using the BI. Despite norm al pulmonary function, all patients with intermittent asthma showed a marke d visible airway inflammation that was reversed by a 4-week treatment with the inhaled steroid budesonide. The present study demonstrates that the BI may be useful as a clinical research tool for the assessment and quantifica tion of airway inflammation in asthma. Furthermore, our results support the widely recognized theory that airway inflammation is present even in patie nts with mild asthma, and emphasize the necessity of an early therapy with inhaled steroids.