Calcitriol, a form of vitamin D synthesized within the body, can possibly minimize growth-factor-induced HASM proliferation in cells in asthmatic as well as non-asthmatic people.

This finding was reported by researchers at the University of Pennsylvania who also noted that Vitamin D can slow down the progressive decline in breathing ability experienced in asthmatic patients due to human airway smooth muscle (HASM) proliferation.

From Sciencedaily.com:

With its anti-inflammatory qualities and its ability to inhibit smooth muscle proliferation, Dr. Damera said, calcitriol may become an important new therapy, used alone or in combination with already prescribed steroids, for treating steroid-resistant asthma.

Dr. Damera and his colleagues have also conducted experiments to determine the mechanism by which calcitriol retards HASM proliferation. They believe the vitamin works by inhibiting activation of distinct set of proteins responsible for cell-cycle progression.

The investigators have also conducted experiments to determine whether calcitriol, which is currently used to treat psoriasis, could be an effective therapy for COPD. Although preliminary, their data shows that calcitriol appears to reduce pro-inflammatory cytokine secretions in COPD. As with asthma, the researchers believe, calcitriol may also have the added benefit of slowing, if not stopping, the progression of airway remodeling. Others in the field believe calcitriol may also have the potential to inhibit the development and growth of several types of cancer.

A randomized control trial of calcitriol in patients with severe asthma with expectations of trial data in a year’s time is now being planned by the researchers as a part of the University of Pennsylvania’s Airway Biology Initiative.

Tags:  asthma, calcitriol, HASM, psoriasis, Steroids, Vitamin D

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Even though steroid treatment is one of the most commonly recommended treatment options for asthma, yet bodies of some children may show no response to such treatment. This finding was disclosed by a new study presented at the American Thoracic Society.

It was suggested that some children may respond well while others may achieve no benefit at all with steroids, as per Gregory Sawicki, M.D. of Children’s Hospital in Boston.

From News-Medical.Net:

“The majority of children with mild asthma are less likely to have symptoms as they get older and may not need to be on daily steroids,” Dr. Sawicki said. “The flip side is that if a child has poor asthma control, the parents and doctor need to make sure the child is adhering to their inhaled steroid treatment. But variation in response to inhaled steroids, as other medications, is well described.”

The data comes from the Child Asthma Management Program Continuation Study (CAMPCS), one of the largest groups of children with mild to moderate asthma in the nation who have been followed over 10 years. “This study gives us a good sense of real-world practice in asthma management,” Dr. Sawicki says. “The children’s care is not directed by anyone in the study; it’s an observation of what goes on when the children’s care is directed by their own physicians.”

It was further noted by Sawicki that asthma control cannot be managed even if higher doses of steroids were administered to non-responsive children, much like all adult asthmatic patients do not derive benefit from steroids.

Tags:  asthma, asthma treatment, inhaled corticosteroids, inhaled steroids

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A potential new treatment approach has been identified for treating severe asthma, as per a small study. The approach is focused up on blocking of a powerful immune system, which is present in large amounts in patients with the severe form of asthma.

It is believed that one out of every ten asthmatics suffers from severe asthma that frequently requires progressively higher doses of steroids for controlling symptoms.

From News-Medical.Net:

Included in the study were 26 healthy people, 67 mild asthmatics, and 51 severe asthmatics. Bronchial fluid and lung tissue samples were taken from the participants to discover their levels of TNF alpha.

Levels were significantly higher in those with severe disease and concentrated in one particular type of immune cell (mast cells) which are recognised components of the inflammatory reaction in asthma.

TNF alpha levels were low and similar in those with no asthma or who only had mild symptoms.

This suggests that the high levels of TNF alpha in severe disease are characteristic of more chronic disease that is resistant to steroid treatment, rather than a feature of the disease itself, say the authors.

The authors caution that that more research is required in this field before the approach can be recommended at any stage but also said that this approach is a potentially new avenue of treatment for severe asthma.

Tags:  asthma, severe asthma, Steroids

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According to a research found in the Journal of Allergy and Clinical Immunology, severe asthma patients can greatly benefit from intravenous immunoglobulin (IVIG) therapy because it was noted to reduce a patient’s sensitivity to steroids as well as it lowers emergency or hospitalization use.

During a 6-month period of study, it was noted that severe asthma patients administered with IVIG therapy had lesser incidence of confinement in hospitals and lesser trips to the emergency room. They were also found to use less glucocorticoids, or generally known as steroids. IVIG was effective both in patients who exhibit steroid insensitivity as well as those who respond normally to steroids. Researchers consider the effect of IVIG in reducing lung sensitivity to glucocorticoids as the reason behind this.

Aside from these benefits, IVIG is also considered to be non-toxic. Although it also has some side effects to it, side effects were still moderate compared to steroids’. Among the detrimental effects of steroids were suppression of bone growth in children and osteoporosis.

IVIG treatment costs a thousand dollars more than the usual method of asthma treatment but it is sure to improve the patient’s quality of life.

According to Eurekalert:

DENVER-People with severe asthma who are “insensitive” to steroids need less of the medication, fewer “bursts” of it in emergencies and spend less time in the hospital when using intravenous immunoglobulin (IVIG) in conjunction with steroids, according to research published today in the Journal of Allergy and Clinical Immunology.

Tags:  asthma, intravenous immunoglobulin

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Schering Plough, a global healthcare company recently announced their latest fixed dose combination for the treatment of asthma patients 12 years of age and above. The combination of mometasone furoate and formoterol fumarate is expected to bring in more sales for the company. Products containing a combination of inhaled corticosteroid and long acting beta-2 agonists (LABs) are the biggest segment in the market.

Mometasone furoate is an inhaled corticosteroid for the maintenance treatment of asthma. It is not recommended for children below 4 years old. On the other hand, formoterol fumarate is a beta-2 agonist, also used for maintenance treatment of asthma patients 5 years and up. Both drugs are not recommended as rescue inhalers, therefore, they are not recommended for use in acute symptoms of asthma.

The company filed a new drug application in the United States Food and Drug Administration for this particular combination. It has been accepted for review and they are hoping that it would be approved for use and distribution in the market. The company owns exclusive rights for manufacturing and distribution of mometasone furoate and formoterol fumarate. This combination comes in a single metered-dose inhaler.

From Medical News Today:

“We are pleased to announce the U.S. filing of the fixed-dose combination of mometasone furoate and formoterol fumarate,” said Thomas P. Koestler, Ph. D., executive vice president and president, Schering-Plough Research Institute. “If approved by the FDA, the mometasone fuorate/formoterol combination would represent an important additional treatment option for physicians and their patients and further strengthen Schering-Plough’s portfolio of respiratory products.”

Tags:  asthma, formoterol fumarate, mometasone furoate

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The potential battle in the war of asthma symptom control can be a psychological one, as per a recently concluded study.

The study went on to reveal that the primary reason why many asthmatic children in the United States do not take their medications as per medical advice is the leeriness of their parents for asthma medications.

Kelly Conn, M.P.H., a senior research coordinator at the University of Rochester Medical Center and lead author of the study, said that asthmatic children can get virtually free from all such symptoms with modern-day preventive medications.

From News-Medical.Net:

To see if parents’ beliefs about their children’s medicines might be influencing how dependably they administered the drugs, the Rochester team analyzed data from parents of 622 children in Southeast Michigan who reported use of at least one preventive asthma medication.

First, parents were asked to complete a Beliefs About Medications Questionnaire (BMQ), a survey that measures two often-conflicting realms of parents’ perceptions of their children’s medications – the necessity, or the extent to which they believed a child’s sickness necessitated taking it, versus the concern, or the extent to which a parent worried about possible risks associated with the drugs, such as side effects and potential for dependency.

Not unlike a “cost-benefit” analysis, a differential score was calculated by subtracting the concern score from the necessity score; this served as a weighed appraisal of each parent’s beliefs.

“We knew that parents often hold opposing attitudes on this issue, almost instinctively. It’s only natural to be caught between worrying about possible dangers related to the medicine and worrying the risks posed by the asthma itself,” Conn said.

The survey showed that, for 77 percent of parents, their perceived need for their child’s medication outweighed concerns about any possible risks. However, 17 percent – one in six parents – composed the opposite camp; they were more concerned about the drugs’ potential to affect harm than they were convinced of their child’s need for them.

Conn further remarked that these findings provide a new paradigm to improve the control of symptoms by just addressing the doubts and worries of parents of asthmatic children. He also said that things can be made better by providing accurate information about side-effects of the medications.

Tags:  asthma, asthma medications, asthma symptom control

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As per scientists from the UT Southwestern Medical Center, addition of corticosteroids to the traditional antimicrobial therapy is an effective option for helping pneumonia patients with quicker recovery than persisting with antibiotics alone.

It was remarked by Dr. Robert Hardy, associate professor of internal medicine and pediatrics and the study’s senior author that while antibiotics are good enough to kill the bug, steroids play an important role for treating lung inflammation.

From News-Medical.Net:

In the current study, mice infected with the M pneumoniae bacterium were treated daily with a placebo, an antibiotic, a steroid, or a combination of the antibiotic and steroid in order to investigate the effect on M pneumoniae-induced airway inflammation. The animals were then evaluated after one, three and six days of therapy.

“It turns out that the group that got both the antibiotic and the steroids did the best,” Dr. Hardy said. “The inflammation in their lungs got significantly better.”

Although antimicrobials remain the primary therapy for M pneumoniae infection, there have been several reports in recent years about physicians adding steroids to the treatment regimen of patients with severe cases, Dr. Hardy said. The problem, he said, is that those were individual case reports.

“They never had a control group, so it was impossible to tell what impact the addition of steroids had on recovery,” he said.

The new findings not only suggest that giving antibiotics with steroids can help individuals with pneumonia get better faster, but also suggest a potentially more effective therapy for someone in the midst of an asthma attack due to M pneumoniae infection. Up to 20 percent of asthma attacks in children and adults have been shown to be triggered by this bacterium.

Dr. Hardy said it’s too early to recommend steroids as standard treatment for people with this type of bacterial pneumonia, but the work does support the need for a clinical trial.

It was suggested that this treatment methodology can open up the doors of a potentially new and effective treatment therapy for patients in the midst of an asthma attack also, which is caused by M pneumoniae infection.

Tags:  antibiotics, antimicrobial therapy, asthma, corticosteroids, M pneumoniae bacterium, pneumonia, Steroids

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According to a study by researchers from the National Jewish Health, being overweight or obese does not put asthma patients under any greater risk than their leaner counterparts though obese asthmatic patients may be slower in relation to medication response.

As per lead author E. Rand Sutherland, Associate Professor of Medicine at National Jewish Health, an improvement in asthmatic condition may not necessarily happen from loss of weight. It was also remarked by the lead author that obese patients may be slower than their leaner counterparts to respond to inhaled corticosteroids, which are the most popular asthma controller medications.

From News-Medical.Net:

Dr. Sutherland and his colleagues decided to examine the issue in a well characterized group of 1,256 patients who had participated in NIH-sponsored studies. They divided them into patients with a body mass index of less than 25 (lean) and greater than or equal to 25 (overweight and obese). They found that lean asthma patients had slightly greater forced expiratory volume in one second, or FEV1 (3.05 liters vs 2.91 liters), and slightly greater ratio of FEV1 to forced vital capacity (83.5% vs. 82.4%), both common measures of lung function. They also found slightly greater use of rescue inhalers among overweight patients (1.2 puffs per day vs. 1.1 puffs per day) and slightly higher scores asthma-relate quality of life questionnaires (5.77 vs. 5.59).

“These differences were small and are unlikely to be of any real clinical significance,” said Dr. Sutherland.

Response to medications, however, did show an effect of increased weight. Among a subgroup of 183 people, lean patients taking inhaled corticosteroids alone showed a 55% greater reduction in exhaled nitric oxide, a measure of inflammation. Lean patients taking a combination inhaled steroid and long-acting beta agonist increased their FEV1 by 80 more milliliters. There were no differences, however, between these patients in the number of asthma exacerbations.

“The data suggest overweight and obese people respond less well to controller medications for asthma than do their lean counterparts,” said Dr. Sutherland. “These data come from already-completed studies designed to answer other questions, however, and ongoing studies are being conducted to more definitively determine the effect of increased weight on treatment response in asthma.”

The study, however, was not sure how and why an increased body weight did not intervene in worsening asthma.

Tags:  asthma, asthmatic patients, inhaled corticosteroids, medication for asthma, obese asthma patients

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The use of inhaled steroids increased significantly in asthmatic women pregnant with a female fetus, but did not change in asthmatic women pregnant with a male. This is because pregnant women with asthma who are carrying a female baby are more likely to experience a worsening of their asthma than pregnant asthmatic women carrying a baby boy.

Although there is no definite reason for this difference, Dr. Gibson believes that female fetus may produce a substance in response to the inflammation of the asthmatic mother’s airways that somehow worsens the asthma.

From Medical News Today:

The study followed 151 pregnant women; 33 did not have asthma, 38 had asthma but did not use inhaled steroids during pregnancy, and 80 had asthma and used inhaled steroids every day during their pregnancy. Steroids control the inflammation of the airways that occurs in asthma. “Inhaled steroids are generally considered safer for the fetus than oral steroids,” Dr. Gibson said.

He found that 60% of asthmatic women who were pregnant with a male fetus were symptom-free throughout their pregnancy and did not report nighttime breathing problems from the 18th to the 30th week of pregnancy. In contrast, 61% of asthmatic women pregnant with a female fetus were symptom-free at 18 weeks, but at 30 weeks only 28% were symptom-free. Nighttime symptoms increased significantly from 18 to 30 weeks in women pregnant with a female fetus.

Use of inhaled steroids increased significantly in asthmatic women pregnant with a female fetus, but did not change in asthmatic women pregnant with a male.

In order to address this condition, Dr. Gibson suggests that pregnant women should continue to treat their asthma with inhaled corticosteroids. According to him, asthma is dangerous to the mother and baby since it can result in reduced oxygen, which is needed for normal fetal growth and development.

Tags:  asthma, Dr. Gibson, female fetus, inhaled steroids, pregnant asthmatic women

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A US research led by Dr Michael Schatz showed that asthmatic pregnant women should continue their inhaled steroids. According to Dr. Schatz, inhaled steroids during pregnancy do not affect the growth of the fetus inside the womb, where as non-medication could result to greater risks on the health of the babies.

The US study looked at the effect of inhaled steroids on the birth weight of children of women with asthma. Researchers compared the birth weights of around 400 babies whose mothers used a range of inhaled steroids for their asthma throughout pregnancy.

From Medical news today:

Inhaled steroids have no effect on the growth of babies in the womb, according to a new study that should offer reassurance for pregnant women with asthma.

But many people with asthma have concerns about their medication: Asthma UK research shows more than 50% are worried about the long-term side effects of steroid treatment, including a possible impact on growth.

‘This study provides reassuring data that specific inhaled steroids do not lead to a restriction in fetal growth,’ said Dr Michael Schatz of the Kaiser Permanente Medical Center, San Diego, who led the research.

Katie Shepherd, Asthma UK’s Care Development Manager, echoed this: ‘It is most important that asthma is well controlled throughout pregnancy. Where inhaled steroids have been prescribed, women with asthma should feel safe taking them, as under-treated asthma can pose a much greater risk to the health of their fetus.’

The study proved that there were no differences between the range of birth weights of the children born to women who undergo treatment and those who are in healthy condition. Also, there were no differences in the numbers of pre-term births or the incidence of low birth weight children. In conclusion, inhaled steroids on pregnant women are safe on both mothers and their babies.

Tags:  asthma, Dr Michael Schatz, inhaled steroids, pregnancy

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