Clinical Study On The Significance Of Airway Inflammatory Indices In The Adjustment Of Asthma Therapy

Objective To investigate the feasibility and clinicalimplication of dynamic changes of lung function parameters, airway hyper-responsiveness (AHR) and airway inflammation indices in induced sputum in patients with mild to moderate asthma who received combined therapy of inhaled corticosteroids and long-acting β₂ agonists in a one-year or more duration to evaluate the airway inflammatory indices as a guide in the adjustment of asthma stepwise therapy.Methods Mild to moderate asthmatic patients who were newlydiagnosed or withdraw of regular therapy for more than one year were enrolled and treated with inhaled corticosteroids combined with long-acting pVagonists.At each visit asthma symptom scores were recorded and FEV₁%,PEF% and PC₃₅sGaw were detected. Meanwhile NO₃^-/NO₂^-concentrations and eosinophils counts in induced sputum were measured until these two indices declined to normal levels.The relativesignificances of lung function parameters and inflammatory indices were analyzed.Results A total of thirty-five subjects were enrolled and twenty-sixsubjects accomplished an one-year or more follow-up, ie.followed-up more than one year in twenty-six cases and more than half and one year in seven cases.In the first 3 monthes,asthma symptom scores,FEVi%,and PEF% were improved significantly, then maintained at relative normal levels in a narrow range. Meanwhile AHR (represented by PC35sGaw ) declined abruptly in the first three months,followed by a slow but continuous improvement from the third to seventh month,then maintained at a very low level.However,only three subject recovered to normal responsiveness. The NCV/NCV and eosinophils counts in induced sputum decreased markedly after combination therapy of one month. The eosinophil counts fell into normal or even zero within three months and NCV/NCV in asthma subjects decreased to normal level at the 7th month. There were significant negative correlations between the concentration of NO3/NO2" in induced sputum and PC35sGaw, however,no correlations were found between PC35sGaw and FEV] % or PEF%.Conclusions The parameters related to airway inflammation including PC35sGaw and sputum NO37NO2" may be valuable in assesing asthma severity,evaluating the efficacy of treatment and adjusting medication regimens.