Document Detail


Acute effects of salmeterol and fluticasone propionate alone and in combination on airway blood flow in patients with asthma.
MedLine Citation:
PMID:  21980058     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The airway contains airway smooth muscle and airway vascular smooth muscle. The acute effects of inhaled long-acting β(2)-adrenergic agonists (LABAs) alone, or in combination with an inhaled glucocorticoid (ICS), on airway smooth muscle tone in asthma are known; however, to the best of our knowledge, their effect on airway vascular smooth muscle tone has not been investigated previously. The objective of this study was to investigate the immediate effects of a LABA and an ICS alone and in combination on airway blood flow (Qaw) as an index of airway vascular smooth muscle tone in patients with stable asthma.
METHODS: Fourteen subjects with moderate asthma inhaled single doses of salmeterol (50 μg), fluticasone propionate (250 μg), salmeterol/fluticasone propionate (50/250 μg), or placebo; Qaw was measured before and serially for 240 min after drug administration.
RESULTS: Mean Qaw increased after salmeterol and salmeterol/fluticasone propionate, with peaks at 60 min of 34% and 40%, respectively, and returned to baseline by 240 min after inhalation. Fluticasone propionate alone caused a transient decrease in mean Qaw. The maximal changes in Qaw, which occurred at different times, were 60% for salmeterol, 67% for salmeterol/fluticasone propionate, and -19% for fluticasone propionate (P < .05 vs placebo for all).
CONCLUSIONS: The LABA salmeterol has an acute vasodilator action on the airway of subjects with stable asthma. The addition of fluticasone propionate, which by itself causes vasoconstriction, does not attenuate the salmeterol-induced vasodilation, suggesting that fluticasone propionate potentiates the vasodilator effect of salmeterol. The vasodilation could be of clinical benefit by promoting the vascular clearance of inflammatory mediators including spasmogens from the airway.
TRIAL REGISTRY: ClinicalTrials.gov; No.: NCT01231230; URL: www.clinicaltrials.gov.
Authors:
Eliana S Mendes; Patricia Rebolledo; Adam Wanner
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Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2011-10-06
Journal Detail:
Title:  Chest     Volume:  141     ISSN:  1931-3543     ISO Abbreviation:  Chest     Publication Date:  2012 May 
Date Detail:
Created Date:  2012-05-03     Completed Date:  2012-06-25     Revised Date:  2012-09-10    
Medline Journal Info:
Nlm Unique ID:  0231335     Medline TA:  Chest     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1184-9     Citation Subset:  AIM; IM    
Affiliation:
Department of Medicine, University of Miami Miller School of Medicine, Miami, FL 33136, USA. emendes@med.miami.edu
Data Bank Information
Bank Name/Acc. No.:
ClinicalTrials.gov/NCT01231230
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MeSH Terms
Descriptor/Qualifier:
Administration, Inhalation
Adult
Airway Resistance / drug effects*
Albuterol / analogs & derivatives*,  therapeutic use
Androstadienes / therapeutic use*
Anti-Asthmatic Agents / therapeutic use*
Asthma / drug therapy*
Blood Flow Velocity / drug effects
Bronchi / blood supply*
Bronchodilator Agents / therapeutic use*
Delayed-Action Preparations
Double-Blind Method
Drug Combinations
Female
Forced Expiratory Volume / drug effects
Glucocorticoids / therapeutic use*
Humans
Male
Middle Aged
Muscle, Smooth / drug effects*
Muscle, Smooth, Vascular / drug effects*
Vasodilation / drug effects*
Vital Capacity / drug effects
Young Adult
Chemical
Reg. No./Substance:
0/Androstadienes; 0/Anti-Asthmatic Agents; 0/Bronchodilator Agents; 0/Delayed-Action Preparations; 0/Drug Combinations; 0/Glucocorticoids; 0/fluticasone, salmeterol drug combination; 18559-94-9/Albuterol; 89365-50-4/salmeterol; 90566-53-3/fluticasone
Comments/Corrections
Comment In:
Chest. 2012 May;141(5):1134-6   [PMID:  22553257 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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