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【科普】他汀联合吸入糖皮质激素不能改善哮喘
NEW YORK (Reuters Health) Jan 06 - In adults with mild-to-moderate atopic asthma, the addition of atorvastatin to inhaled corticosteroid therapy leads to a reduction in the sputum macrophage count but no short-term improvements in lung function, according to results of a study conducted in the UK.
"Statins have anti-inflammatory properties, including the ability to reduce airway inflammation in animal models of allergic lung inflammation, and therefore may be useful in the treatment of asthma," Professor Neil C. Thomson from University of Glasgow noted in comments to Reuters Health.
"Based on these pre-clinical findings, we undertook a clinical study of atorvastatin in patients with mild allergic asthma in the hope that treatment with a statin might improve asthma control," he further explained.
In a double-blind randomized study, 54 adults with atopic asthma received atorvastatin (40 mg daily) or matching placebo for 8 weeks. After a 6-week washout period, the patients crossed over to the other treatment for 8 weeks.
At 8 weeks, the change in mean morning peak expiratory flow compared with baseline did not differ substantially between atorvastatin and placebo treatment, Professor Thomson and colleagues report in the current issue of the journal Thorax.
Likewise, values for other indices of lung function, including forced expiratory volume in 1 second and airway hyperresponsiveness to methacholine challenge, were similar between the atorvastatin and placebo treatment periods.
"There were, however, changes in airway inflammation and, in particular, a reduction in the absolute sputum macrophage count after atorvastatin compared with placebo and an associated reduction in sputum leukotriene B4," the investigators report.
"The reduction in the sputum macrophage count suggests potential areas for investigation of atorvastatin in chronic lung disease in which activated alveolar macrophages have been implicated in the pathogenesis, such as COPD," the study team concludes.
As expected, atorvastatin produced a highly significant drop in cholesterol after 8 weeks.
他汀联合吸入糖皮质激素不能改善哮喘控制
（纽约路透电）1月6日-成人轻-中度变应性哮喘，吸入糖皮质激素同时添加阿托伐他汀，导致痰巨噬细胞计数减少，但没有短期肺功能改善，根据英国进行的一项研究结果。
格拉斯哥大学汤姆逊教授在路透社评论的指出，“他汀类具有抗炎特性，包括减轻变应性肺部炎症动物模型气道炎症，因此可能有益于哮喘治疗”。
“基于这些临床前研究结果，我们对轻度过敏性哮喘患者进行了阿托伐他汀的临床研究，期望他汀治疗可以改善哮喘的控制，”作者进一步解释。
在随机双盲研究中，54个成人特应性哮喘患者接受阿伐他汀（40毫克/天）或匹配安慰剂8周。经过6周洗脱期，患者越过其他治疗8周。
至第8周，与基线相比，阿托伐他汀和安慰剂治疗组早晨最大呼气流量均值差异不明显，汤姆森教授和他的同事在最新一期Thorax杂志报道。
同样，阿托伐他汀和安慰剂治疗期，肺功能的其他指标值包括一秒用力呼气容积及乙酰甲胆碱激发的气道高反应性类似。
“然而，阿托伐他汀与安慰剂相比，气道炎症变化特别是痰巨噬细胞绝对计数减少伴随痰白三烯B4减少，” 研究者报告。
“痰巨噬细胞计数减少表明阿托伐他汀在肺泡巨噬细胞活化参与发病的慢性肺部疾病如慢性阻塞性肺病具有潜在研究空间，”研究小组得出的结论。
正如所料，使用阿伐他汀8周后胆固醇显著下降。
Thorax 2008;63:1070-1075. [标签:content1][标签:content2]
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作者:admin@医学,生命科学 2011-07-29 17:11
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