Journal
EUROPEAN RESPIRATORY JOURNAL
Volume 21, Issue 6, Pages 989-993Publisher
EUROPEAN RESPIRATORY SOC JOURNALS LTD
DOI: 10.1183/09031936.03.00072402
Keywords
asthma; bronchial blood flow; corticosteroid vasoconstriction
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The vasoconstrictive efficacies of glucocorticosteroids (GS) are usually compared by the McKenzie skin-blanching test and taken as an index of relative potency. The rationale for the present study was to transpose the McKenzie test to the airway and to compare the airway vascular effects of three inhaled GS: beclomethasone dipropionate (BDP), fluticasone propionate (FP) and budesonide (BUD), in healthy subjects and patients with mild stable asthma. A soluble, inert gas-uptake method was used to measure airway blood flow (Q(aw)). Baseline mean +/- SD Q(aw) normalised for anatomical dead space was 53.1 +/- 1.4 muL.min(-1).mL(-1) in healthy subjects (n = 10) and 67.8 +/- 3 muL.min(-1).mL(-1) in asthmatics (n = 10). All GS caused a transient decrease in Q(aw). The magnitude of the vasoconstriction was greater in asthmatics. The relative vasoconstrictive effect of BDP, FP and BUD was 1, 1.9, and 2.7, respectively, in asthmatics and 1, 3.3 and 3.0, respectively, in healthy subjects, as assessed by the dose required to decrease Q(aw) by 20% from the baseline, 30-min postdrug inhalation. Therefore, measuring airway blood flow may be a useful, site-specific parameter to assess the tissue bioavailability and vasoconstrictive efficacy of inhaled glucocorticosteroids.
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