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Intranasal fluticasone propionate for chronic eosinophilic rhinitis in patients with aspirin-induced asthma (1997)

Mastalerz, L. ; Milewski, M. ; Duplaga, M. ; [et al.]

Oxford, UK : Blackwell Publishing Ltd

Allergy 52 (1997), S. 0

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ISSN: 1398-9995

Source: Blackwell Publishing Journal Backfiles 1879-2005

Topics: Medicine

Notes: We performed a double-blind, crossover, placebo-controlled study on the effect of fluticasone propionate (FP) treatment on chronic eosinophilic rhinosinusitis in 15 patients with aspirin-induced asthma (AIA). There were 10 women and five men aged 32–60 years; average: 45 years. After a 10-day run-in period, patients underwent two 4-week treatment courses (FP vs placebo), separated by a 2-week washout interval. Clinical activity of FP was evaluated by daily measurement of peak nasal inspiratory flow (PNIF) and a scoring system of subjective symptoms. Nasal challenges with L-lysine aspirin, using active anterior rhinomanometry, were performed at the entry and on the last day of each treatment period. Weekly mean values of symptom scores were generally lower and PNIF measurements higher during treatment with FP than with placebo. This difference was statistically significant for most recorded parameters for the whole 4-week FP treatment. On average, the reactions evoked by aspirin nasal challenge were significantly shorter and milder after treatment with FP than with placebo. In 8/13 patients, FP completely prevented aspirin-precipitated nasal reaction, whereas protection after placebo was observed in only 2/12 subjects (P=0.004). We conclude that intranasal FP is an effective therapy for chronic eosinophilic rhinitis in patients with AIA.

Type of Medium: Electronic Resource

URL: http://dx.doi.org/10.1111/j.1398-9995.1997.tb01248.x

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Protection against exercise-induced bronchoconstriction by montelukast in aspirin-sensitive and aspirin-tolerant patients with asthma (2002)

Mastalerz, L. ; Gawlewicz-Mroczka, A. ; Cmiel, A. ; [et al.]

Oxford, UK : Blackwell Science, Ltd

Clinical & experimental allergy 32 (2002), S. 0

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ISSN: 1365-2222

Source: Blackwell Publishing Journal Backfiles 1879-2005

Topics: Medicine

Notes: Background Montelukast, a cysteinyl-leukotriene receptor antagonist, was reported to have a protective effect against exercise-induced bronchoconstriction (EIB). Aspirin-induced asthma (AIA) is characterized by overproduction of cysteinyl-leukotrienes.Objective The aim of the study was to compare the response to exercise and the effect of montelukast on EIB in AIA as compared to aspirin-tolerant asthma (ATA).Methods A placebo-controlled, double blind, cross-over randomized study was performed in 19 AIA and 21 ATA patients with stable asthma. A single dose of montelukast (10 mg) or placebo (PL), was given orally one hour prior to exercise challenge. FEV1 was measured before and 5, 10, 15 min after exercise and then at 15-minute intervals for 4 h. Urinary LTE4 excretion and blood eosinophil count were measured at baseline, 2 h and 4 h following exercise challenge.Results Positive bronchial response to exercise was observed in 47.5% of all patients studied. Exercise led to almost identical maximal fall in FEV1 in AIA and ATA patients (23.5% ± 6.8% vs. 21.8% ± 12.0%, respectively; P = 0.7). Montelukast, as compared to PL, significantly attenuated EIB in 63.2% of 19 patients with positive exercise test preceded by PL. The mean of maximum fall in FEV1 from the pre-exercise value was 10.2% ± 13.8 after montelukast as compared to 22.5% ± 10.2 after placebo (P 〈 0.001). No significant differences between protective effect of montelukast was observed in AIA as compared to ATA patients (P = 0.63, anova). Urinary LTE4 excretion showed no change following exercise, irrespective of the result of the test in all subjects.Conclusion Patients with AIA and ATA react similarly to exercise challenge and obtain similar protection against EIB by montelukast.

Type of Medium: Electronic Resource

URL: http://dx.doi.org/10.1046/j.1365-2745.2002.01484.x

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A moderate and unspecific release of cysteinyl leukotrienes by aspirin from peripheral blood leucocytes precludes its value for aspirin sensitivity testing in asthma (2000)

Pierzchalska, M. ; Mastalerz, L. ; Sanak, M. ; [et al.]

Oxford, UK : Blackwell Science, Ltd

Clinical & experimental allergy 30 (2000), S. 0

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ISSN: 1365-2222

Source: Blackwell Publishing Journal Backfiles 1879-2005

Topics: Medicine

Notes: Aspirin-induced asthma (AIA) is a clinical syndrome related to cysteinyl leukotriene overproduction in airways. The confirmation of the diagnosis requires inconvenient provocation tests with acetyl salicylic acid (ASA).A study was performed to evaluate whether measurement in vitro of cysteinyl leukotrienes (cys-LTs) release by isolated peripheral blood leucocytes, stimulated with ASA, can be of use for diagnosis of AIA.A cellular allergen stimulation test, CAST, was adapted to measure leukotriene release from leucocytes of 32 aspirin-tolerant and 26 aspirin-intolerant asthmatics. The cells were stimulated with Lys-ASA, N-formyl-methionyl-leucyl-phenylalanine (fMLP), or both fMLP and Lys-ASA, in a buffer containing IL-3, and results compared with human leukaemia cell line (Hl-60) response to Lys-ASA. Cys-LTs were measured in cell supernatant fluids by ELISA.ASA had a rather week stimulatory effect on cys-LTs release in both groups of patients. Contrary to some previous studies, no significant differences were found between cys-LTs release by leucocytes from AIA and ATA, or by differentiated Hl-60 cells.Measurement of cysteinyl-leukotriene release by peripheral blood leucocytes pre-treated with aspirin has no value for diagnosis of AIA.

Type of Medium: Electronic Resource

URL: http://dx.doi.org/10.1046/j.1365-2222.2000.00953.x

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Serum interleukin-5 in aspirin-induced asthma (2001)

Mastalerz, L. ; Sanak, M. ; Szczeklik, A.

Oxford, UK : Blackwell Science, Ltd

Clinical & experimental allergy 31 (2001), S. 0

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ISSN: 1365-2222

Source: Blackwell Publishing Journal Backfiles 1879-2005

Topics: Medicine

Notes: Background Eosinophilopoetic cytokine IL-5 enhances cysteinyl-leukotriene (cys-LT) synthesis in eosinophils in vitro. In patients with aspirin-induced asthma (AIA) bronchial biopsies revealed eosinophil infiltration and a marked increase in IL-5 positive cells.Objective We wondered whether in AIA patients the bronchial IL-5 increase is reflected in peripheral blood, and if so, whether it is related to overproduction of cys-LT.Methods In 11 stable patients with AIA, 32 with ATA (aspirin-tolerant asthma) and in 16 controls we measured serum IL-5 concentrations and urinary LTE4, believed to reflect global cys-LT production.Results Serum IL-5 was detectable in 12 of 43 asthmatics, but in none of the control subjects. It was highest in the ATA group and differed significantly from the controls. There was no significant difference in IL-5 levels between: (i) the asthmatic groups studied, and (ii) AIA patients and controls. No relationship was found between serum IL-5 and urinary cys-LT.Conclusion Overexpression of IL-5 reported in the airways of aspirin-sensitive patients with asthma was not reflected in their blood. If IL-5 affects cys-LT production, it is rather in the bronchi of the patients than in the blood.

Type of Medium: Electronic Resource

URL: http://dx.doi.org/10.1046/j.1365-2222.2001.01105.x

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Urinary leukotriene levels are increased during exacerbation of atopic eczema/dermatitis syndrome. Relation to clinical status (2002)

Adamek-Guzik, T. ; Guzik, T. J. ; Czerniawska-Mysik, G. ; [et al.]

Oxford, UK : Munksgaard International Publishers

Allergy 57 (2002), S. 0

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ISSN: 1398-9995

Source: Blackwell Publishing Journal Backfiles 1879-2005

Topics: Medicine

Notes: Background: Leukotrienes are potent mediators of allergic inflammation and their role in the pathogenesis of allergic disorders, particularly asthma, is well established. Their importance in the pathogenesis of atopic eczema/dermatitis syndrome (AEDS) is still unclear. We aimed to compare urinary cysteinyl leukotriene (Cys-LT) levels during exacerbation and remission of AEDS in relation to clinical status, IgE levels, and eosinophil counts. Methods: Urinary Cys-LTs were measured by direct enzyme immunoassay in 17 adult patients with AEDS and in 17 healthy controls in whom atopy had been excluded. Cys-LTs were compared during exacerbation and remission of AEDS in relation to the clinical status measured by SCORAD. Total IgE levels were measured by enzyme-linked immunoassay (ELISA). Results: Mean clinical score during the exacerbation was 64.3 ± 3.1 and during remission 22.4 ± 4 ( P 〈 0.01). Cys-LTs levels were significantly higher during the exacerbation of AEDS than in the control group (230.9 ± 20.8 vs 123.2 ± 9.9 pg/mg creatinine; P 〈 0.005). During the remission, the difference between AEDS patients and the control group was not significant (96.3 ± 8.7 vs 123.2 ± 9.9 pg/mg creatinine; P = 0.8). During AEDS exacerbation Cys-LTs levels were significantly correlated with the clinical status ( r S = 0.73, P 〈 0.01) and with eosinophil counts ( r = 0.86; P 〈 0.01) but not with the duration of the disease, age of patients, or IgE levels. Conclusions: Our results point to enhanced biosynthesis of Cys-LTs during the AEDS exacerbations. Inflammatory cells, e.g. eosinophils are the most probable source of Cys-LTs. A strong correlation between Cys-LT levels and clinical status may in part explain preliminary clinical observations of efficacy of leukotriene antagonists in alleviating symptoms of AEDS.

Type of Medium: Electronic Resource

URL: http://dx.doi.org/10.1034/j.1398-9995.2002.23688.x

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