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1.
Journal of Traditional Chinese Medicine ; (12): 72-78, 2024.
Article in Chinese | WPRIM | ID: wpr-1005114

ABSTRACT

ObjectiveTo investigate the efficacy and safety of cinobufagin tablets combined with thalidomide/dexamethasone (TD) regimen in the treatment of newly diagnosed multiple myeloma (NDMM) with phlegm and stasis obstruction. MethodsThe clinical data of 50 patients with NDMM of phlegm and stasis obstruction who were hospitalized at the Jiangsu Province Hospital of Chinese Medicine from June 1st, 2015 to July 31th, 2019 were retrospectively analyzed, and they were divided into a control group (bortezomib/dexamethasone-containing regimen, 27 cases) and an observation group (cinobufagin tablets combined with TD regimen, 23 cases). The clinical efficacy and safety were compared between the two groups after two or three courses of treatment. The primary outcomes were clinical remission rate including overall response rate and deep remission rate, one-year and two-year overall survival rate, and adverse effects. The secondary outcomes were the proportion of plasma cells in bone marrow, hemoglobin, β2-microglobulin, lactate dehydrogenase, serum creatinine, blood urea nitrogen, bone pain score, and KPS functional status score (KPS score) before and after treatment. ResultsIn terms of clinical efficacy, there was no statistically significant difference (P>0.05) in the overall response rate [the observation group 69.57%(16/23) vs the control group 70.37% (19/27)] and deep remission rate [the observation group 56.52% (13/23) vs the control group 55.56% (15/27)] between groups after the treatment. The one-year overall survival rates of the observation group and the control group were 90.9% and 92.4%, and the two-year overall survival rates were 81.8% and 80.9% respectively, with no statistically significant differences between groups (P>0.05). During the treatment, no renal function injury occurred in both groups. The incidence of peripheral nerve injury in the observation group was 8.70%, which was lower than 48.15% in the control group (P<0.01). After the treatment, the proportion of myeloma plasma cells, β2-microglobulin, serum creatinine level, and bone pain score decreased, while the hemoglobin level and KPS score increased in both groups (P<0.05 or P<0.01). Compared between groups after treatment, the bone pain score of the observation group was lower than that of the control group, while the KPS score was higher than that of the control group (P<0.05). ConclusionThe clinical efficacy of cinobufagin tablets combined with TD in the treatment of NDMM is equivalent to bortezomib/dexamethasone-containing regimen, but the former is more helpful in relieving the pain and improving the quality of life, and has better safety.

2.
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery ; (12): 690-698, 2023.
Article in Chinese | WPRIM | ID: wpr-996579

ABSTRACT

@#Objective     To investigate the influencing factors for the clinical remission of advanced esophageal squamous cell carcinoma (ESCC) after neoadjuvant chemotherapy, establish an individualized nomogram model to predict the clinical remission of advanced ESCC with neoadjuvant chemotherapy and evaluate its efficacy, providing serve for the preoperative adjuvant treatment of ESCC. Methods     The clinical data of patients with esophageal cancer who underwent neoadjuvant chemotherapy (nedaplatin 80 mg/m2, day 3+docetaxel 75 mg/m2, day 1, 2 cycles, 21 days per cycle interval) in the Department of Thoracic Surgery, Affiliated Hospital of North Sichuan Medical College from February 2016 to August 2020 were analyzed retrospectively. According to the WHO criteria for efficacy assessment of solid tumors, tumors were divided into complete remission (CR), partial remission (PR), stable disease (SD) and progressive disease (PD). CR and PR were defined as effective neoadjuvant chemotherapy, and SD and PD were defined as ineffective neoadjuvant chemotherapy. Univariate and multivariate analyses were used to analyze the influencing factors for the short-term efficacy of neoadjuvant chemotherapy. The R software was used to establish a nomogram model for predicting of the model. C-index, calibration curve and receiver operating characteristic (ROC) curve were used to evaluate the predictive performance of the nomogram. Results     Finally 115 patients were enrolled, including 93 males and 22 females, aged 40-75 (64.0±8.0) years. After receiving docetaxel+nedaplatin neoadjuvant chemotherapy for 2 cycles, there were 9 patients with CR, 56 patients with PR, 43 patients with SD and 7 patients with PD. Among them, chemotherapy was effective (CR+PR) in 65 patients and ineffective (SD+PD) in 50 patients, with the clinical effective rate of about 56.5%(65/115). Univariate analysis showed that there were statistical differences in smoking history, alcoholism history, tumor location, tumor differentiation degree, and cN stage before chemotherapy between the effective neoadjuvant chemotherapy group and the ineffective neoadjuvant chemotherapy group (P<0.05). Logistic regression analysis showed that low-differentiation advanced ESCC had the worst clinical response to neoadjuvant chemotherapy, moderately-highly differentiated ESCC responded better (P<0.05). Stage cN0 advanced ESCC responded better to neoadjuvant chemotherapy than stage cN1 and cN2 (P<0.05). The C-index and the area under the ROC curve of the nomogram were both 0.763 (95%CI 0.676-0.850), the calibration curve fit well, the best critical value of the nomogram calculated by the Youden index was 70.04 points, and the sensitivity and specificity of the critical value were 80.0% and 58.0%, respectively. Conclusion    The established clinical prediction model has good discrimination and accuracy, and can provide a reference for individualized analysis of the clinical remission of advanced ESCC with neoadjuvant chemotherapy and the screening of new adjuvant treatment subjects.

3.
Chinese Journal of Radiation Oncology ; (6): 525-531, 2022.
Article in Chinese | WPRIM | ID: wpr-932700

ABSTRACT

Objective:To investigate the long-term prognosis and failure mode of patients with esophageal squamous cell carcinoma who achieved clinical complete remission (cCR) after receiving radical radio (chemo) therapy.Methods:Clinical data of 183 patients with esophageal squamous cell carcinoma eligible for inclusion criteria who received treatment in our hospital from January 2009 to December 2012 were retrospectively analyzed. The factors that affected the long-term prognosis of patients were identified, and the failure mode of cCR patients and the prognosis after failure were analyzed. SPSS 19.0 statistical software was used for data analysis.Results:As of the follow-up date, the 1-, 3-, 5-, and 10-year overall survival (OS) rates and disease-free survival (DFS) rates of the entire group were 83.1%, 53.4%, 36.2%, 12.8% and 68.9%, 45.9%, 30.5%, 12.0%, respectively. The median OS and DFS were 41.3 months and 33.4 months. The results of multivariate analysis showed that cT staging, cN staging and prescribed dose were the independent factors affecting the OS ( P=0.001, <0.001, 0.003); hoarseness, lesion length, cT staging, cN staging and prescribed dose were the independent factors that affected the DFS ( P=0.002, 0.033, 0.009, <0.001, 0.003). In the whole group, 72 cases (39.3%) had local regional recurrence, 58 cases (31.7%) had distant metastasis, and 26 cases (14.2%) had local regional recurrence with distant metastasis. Among 104 patients after treatment failure, the prognosis of patients receiving salvage treatment was significantly better than that of their counterparts receiving maintenance treatment ( χ2=39.153, P<0.001). Conclusions:The long-term prognosis of patients with esophageal squamous cell carcinoma who achieved cCR after receiving radical radio (chemo) therapy is still unsatisfactory. Clinically, it is necessary to strengthen the clinical observation and follow-up of these patients. The main treatment failure mode of cCR patients is local regional recurrence. Active salvage treatment can significantly improve clinical prognosis of these patients.

4.
Journal of Xi'an Jiaotong University(Medical Sciences) ; (6): 93-98, 2021.
Article in Chinese | WPRIM | ID: wpr-1006777

ABSTRACT

【Objective】 To evaluate musculoskeletal ultrasound (MSUS) detected subclinical synovitis of rheumatoid arthritis (RA) with different clinical remission criteria so as to explore the clinical characteristics of subclinical synovitis. 【Methods】 Forty-six consecutive patients with RA in clinical remission [disease activity score-28 (DAS28)≤2.6] underwent clinical and MSUS examinations at baseline and 1 year follow-up. Clinical remission was defined according to the DAS28 using the erythrocyte sedimentation rate (DAS28-ESR) and C-reactive protein level (DAS28-CRP), clinical disease activity index (CDAI), simplified clinical disease activity index (SDAI), and American College of Rheumatology/European League Against Rheumatism criteria Boolean (ACR/EULAR criteria). Subclinical synovitis was assessed by MSUS. Differences between the subclinical synovitis and non-subclinical synovitis groups were analyzed. 【Results】 The percentages of patients who achieved DAS28-ESR, DAS28-CRP, CDAI, SDAI, and ACR/EULAR remission at baseline and 1 year were 97.8%, 95.6%, 67.4%, 54.3%, 52.2% and 91.3%, 93.5%, 54.3%, 50.0%, and 45.6%, respectively. Subclinical synovitis was detected in 55.5%, 54.5%, 45.2%, 40.0%, 41.6% and 45.2%, 46.5%, 40.0%, 39.1%, and 38.1% of these patients, respectively. There were 45.6% and 41.3% patients who fulfilled all the criteria, yet 38.1% and 36.8% still had evidence of subclinical synovitis at baseline and 1 year. Compared with the patients without subclinical synovitis, those with subclinical synovitis had a significantly positive rate of anti-CCP antibody and a higher disease activity score at baseline (P<0.05). 【Conclusion】 MSUS detected subclinical synovitis is common. The positive anti-CCP antibody and higher disease activity score at baseline may be related to subclinical synovitis in patients with RA in clinical remission.

5.
Article | IMSEAR | ID: sea-210527

ABSTRACT

Ulcerative colitis (UC) is a long-term disorder that associated with overactivation of immunoinflammatory system,ending with ulcer in the large intestine. This study aimed to compare the activity and toxicity of different TNF-alphainhibitors in a sample of Iraqi patients having active ulcerative colitis. Fifty patients with refractory ulcerative colitiswere randomly distributed to either group I (n = 25): on adalimumab injection (160/80 mg) or group II (n = 25): oninfliximab injection (5 mg/kg) along the term of induction. Clinical remission was considered as the primary subjectiveparameter, while clinical response, mucosal healing, and subscores of mild status were regarded as secondary subjectiveparameters. Fractional Mayo score, inflammatory bowel disease questionnaire (IBDQ), and safety profile were alsoevaluated. A 24% versus 28% patients were in clinical remission for those receiving adalimumab and infliximab,respectively (p > 0.05), while 48% versus 52% patients were in clinical response for those receiving adalimumab andinfliximab, respectively (p > 0.05), and 40% of patients acquired mucosal healing for both adalimumab and infliximabarms (p > 0.05). Scores of physician assessment and rectal bleeding was shown to be markedly higher in infliximabpatients (p < 0.05), while those of stool frequency was found to be higher in adalimumab patients (p < 0.05). Nosignificant difference was observed between two arms in the fractional Mayo score and IBDQ index (p > 0.05).Both of the studied biological agents were well-tolerated. As conclusion, the two different TNF-alpha inhibitors werecomparable in their clinical remission and safety profile for subjects with active ulcerative colitis.

6.
Journal of China Medical University ; (12): 153-158, 2019.
Article in Chinese | WPRIM | ID: wpr-744818

ABSTRACT

Objective To investigate the predictive value of serum survivin for clinical efficacy of tumor necrosis factor-α (TNF-α) inhibitor treatment in rheumatoid arthritis (RA) patients. Methods This study enrolled 63 consecutive patients with moderate or severe RA who received TNF-α inhibitor via subcutaneous injection 2 times/week, 25 mg/dose, for 24 weeks. According to disease activity, patients were also administered a disease-modifying antirheumatic drug. Serum survivin level was measured by enzyme-linked immunosorbent assay. The Disease Activity Score 28 was assessed, and clinical response and clinical remission were investigated. Results After treatment, 41 patients had a clinical response and 22 had no response. Baseline serum survivin level was reduced in the responder group compared to that in the non-responder group (P = 0.004). Receiver operating characteristic curve analysis showed that survivin level had good predictive value for non-response to TNF-α inhibitor treatment in RA patients (area under the curve:0.717, 95% confidence interval:0.583-0.852). High survivin level (≥672.75 pg/mL) was an independent predictor of non-response to TNF-α inhibitor treatment in RA patients (P = 0.011), while a high C-reactive protein (CRP) level was an independent predictor of a better response to TNF-α inhibitor treatment (P = 0.011). High survivin level predicted non-response to TNF-α inhibitor treatment, independent of CRP level. However, baseline survivin level showed no difference between remission (16 cases) and non-remission groups (47 cases) (P = 0.265). A high survivin level did not affect remission in RA patients after TNF-α inhibitor treatment. Conclusion Baseline serum survivin level can predict the response of RA patients to TNF-α inhibitor treatment.

7.
Chinese Journal of Digestive Surgery ; (12): 279-284, 2019.
Article in Chinese | WPRIM | ID: wpr-743971

ABSTRACT

Objective To investigate the application value of magnetic resonance imaging (MRI) examination in the efficacy evaluation of infliximab combined with seton placement for perianal fistulizing Crohn's disease (PFCD) and influencing factors of deep remission.Methods The retrospective case-control study was conducted.The clinicopathological data of 57 patients with PFCD who were admitted to the Affiliated Hospital of Nanjing University of Chinese Medicine from August 2010 to October 2017 were collected.There were 39 males and 18 females,aged (24±9)years,with a range of 14-58 years.Patients underwent MRI examination preoperatively and postoperatively.Observation indicators:(1) follow-up situations;(2) influencing factors analysis of deep remission of PFCD.Follow-up using outpatient and inpatient reexamination was performed to detect clinical recovery of patients up to October 2017.Measurement data with normal distribution were represented as Mean±SD.Measurement data with skewed distribution were described as M (range).Count data were represented as absolute number or percentage.The univariate analysis was performed using the chi-square test.The multivariate analysis was done using the logistic regression model,using P<0.15 as an inclusion criteria in the univariate analysis.Results (1) Follow-up situations:57 patients with PFCD undergoing inflixmab combined with seton placement were followed up for (40±24)months.During the follow-up,24 of 57 patients had clinical response,33 had long-term clinical healing.The fistulas of 24 patients with clinical response presented as high signal on T2 weighted image (T2WI) of postoperative MRI.Of 33 patients with long-term clinical healing,the fistulas of 16 patients with deep remission presented loss of high signal and replacement of fibrosis tissue on T2WI of postoperative MRI,the fistulas of 17 patients without deep remission presented as high signal on T2WI of postoperative MRI.(2) Influencing factors analysis of deep remission of PFCD:results of univariate analysis showed that extent of fistula was related factors affecting deep remission of PFCD (x2 =4.312,P<0.05).Results of multivariate analysis showed that a single fistula complicated with branches and times of infliximab maintenance treatment ≤3 were independent risk factors affecting deep remission of PFCD (odds ratio=4.377,4.296,95% confidence interval:1.124-17.043,1.158-15.940,P<0.05) and fistula under levator ani muscle was an independent protective factor affecting deep remission of PFCD (odds ratio =0.182,95% confidence interval:0.041-0.815,P< 0.05).Conclusions Partial patients with long-term clinical healing can achieve deep remission after Infliximab combined with seton placement for perianal fistulizing Crohn's disease,requiring MRI examination to further evaluate recovery situations.A single fistula complicated with branches and times of infliximab maintenance treatment ≤ 3 are independent risk factors affecting deep remission of PFCD and fistula under levator ani muscle is an independent protective factor affecting deep remission of PFCD.

8.
Yonsei Medical Journal ; : 144-149, 2017.
Article in English | WPRIM | ID: wpr-65051

ABSTRACT

PURPOSE: Our aim was to evaluate the efficacy and safety of oral beclomethasone dipropionate (BDP) in Korean patients with ulcerative colitis (UC). MATERIALS AND METHODS: The medical records of patients with active UC who were treated with BDP were retrospectively reviewed. Partial Mayo Clinic score (pMS) was calculated to determine disease activity. After 4 weeks of therapy, clinical remission, clinical response, and response failure rates were evaluated. Clinical remission was defined as a post-treatment pMS of 0 or 1, clinical response as a decrease of two of three points in pMS and >30% from baseline, and response failure as a lack of clinical response. Also, we considered that clinical remission was included in clinical response. RESULTS: Between July 2013 and April 2015, 95 patients with UC received BDP therapy at our institution (median age, 44 years; range, 12–81 years). After 4 weeks of therapy, clinical remission and clinical response rates were 50.5% and 73.7%, respectively. Mean change of pMS before and after BDP therapy was 2.4. There was no significant side effect reported. In multivariate analysis, disease activity was the only factor associated with a favorable response. Clinical remission rate was significantly higher in the mild disease activity group (66.7%) than that in the moderate or severe disease activity group (41.9%) (p=0.024). CONCLUSION: BDP is efficacious in inducing a clinical response or remission in Korean patients with UC. Patients with mild UC were more likely to be in remission than those with moderate or severe UC after receiving BDP for 4 weeks. BDP exhibited a good safety profile.


Subject(s)
Female , Humans , Male , Young Adult , Administration, Oral , Anti-Inflammatory Agents/administration & dosage , Beclomethasone/administration & dosage , Colitis, Ulcerative/drug therapy , Drug-Related Side Effects and Adverse Reactions , Medical Records , Remission Induction , Republic of Korea , Retrospective Studies , Safety , Treatment Outcome
9.
Rev. colomb. gastroenterol ; 30(3): 279-284, jul.-sep. 2015. ilus, tab
Article in Spanish | LILACS | ID: lil-765604

ABSTRACT

Introducción: los estudios de azatioprina (AZA) en el tratamiento de colitis ulcerativa (CU) son escasos y la mayoría tiene más de una década. Es necesario establecer la eficacia de AZA en nuestro medio, en sujetos con respuesta inadecuada a esteroides. Objetivo: evaluar en nuestra población la respuesta clínica a AZA, tanto a corto como a largo plazo, en CU con respuesta inadecuada a esteroides. Materiales y métodos: se realizó un estudio descriptivo retrospectivo, revisando historias clínicas entre agosto de 2001 y mayo de 2014 de 215 pacientes con CU incluidos en nuestra base de datos del Hospital "Pablo Tobón Uribe", de los cuales 69 (32%) habían recibido AZA. 30 pacientes recibieron al menos 3 meses de tratamiento con AZA en dosis óptima de al menos 2,0 mg/kg, por respuesta inadecuada a esteroides, y fueron incluidos en el estudio. Resultados: el seguimiento promedio de los pacientes fue de 20 meses (3 meses-72 meses). Se encontró remisión clínica en 17 (57%) de 30 pacientes y respuesta parcial en 12 de 30 sujetos (40%) durante 3 meses de tratamiento. Al año, de los 30 pacientes iniciales, 16 (53%) mantenían remisión clínica, 3 (10%) respuesta parcial y 5 (17%) presentaron recaídas y recibieron terapia biológica. 16 pacientes (53%) lograron suspensión de esteroides al año de seguimiento. Ningún paciente requirió colectomía. Conclusiones: este estudio demuestra una tasa de remisión clínica de 53% con AZA en CU leve a moderada al año de seguimiento, logrando suspender esteroides en el 53% de los pacientes. AZA es una opción terapéutica de bajo costo y segura, que puede considerarse en este grupo de pacientes previo al inicio de terapia biológica.


Introduction: Because there are very few studies of the use of azathioprine (AZA) for treatment of ulcerative colitis, and most are more than a decade old, we need to establish the efficacy of AZA in our environment for patients who have responded inadequately to steroids. Objective: The objective of this study is to evaluate short and long term clinical responses to AZA by ulcerative colitis patients in our population who have had inadequate responses to treatment with steroids. Materials and Methods: This is a retrospective study based on a database review of the medical records of 215 ulcerative colitis patients treated at the Hospital Pablo Tobon Uribe between August 2001 and May 2014. Sixty-nine patients (32%) had received AZA, and 30 patients had received at least 3 months of treatment with AZA at the optimal dose of at least 2.0 mg/kg after having responded inadequately to treatment with steroids. This group was included in the study. Results: The median follow-up time was 20 months with a range from three months to 72 months. After three months of treatment, clinical remission was found in 17 patients (57%) out of 30 patients, and partial responses were found in 12 out of 30 subjects (40%). A year after the initial follow-up, 16 patients (53%) maintained clinical remission, three (10%) continued to have partial responses, and five (17%) had relapsed and had received biological therapy. Sixteen patients (53%) achieved one year with steroid treatment suspended and no patients required colectomies. Conclusions: This study demonstrates a clinical remission rate of 53% for patients with mild to moderate ulcerative colitis who were treated with AZA. One year follow-ups showed that continuous suspension of steroid treatment had been achieved in 53% of patients. AZA is an inexpensive and safe therapeutic option which can be considered prior to initiating biological therapy for these patients.


Subject(s)
Humans , Azathioprine , Colitis, Ulcerative , Referral and Consultation
10.
Chongqing Medicine ; (36): 1085-1086,1090, 2015.
Article in Chinese | WPRIM | ID: wpr-600427

ABSTRACT

Objective To explore the value of exhaled nitric oxide evaluate the condition of children with asthma in clinical remission stage .Methods A total of 214 asthmatic children were divided into treatment group and control group .Tests of bronchial provocation and FeNO were performed at the same time .Results FeNO in treatment group was significantly lower than in control group ,while the level of PC20 FEV1 did not have obvious difference in two groups .The level of PC20 FEV1 was negatively correlated with FeNO ,regression equation was Y=35 .883-1 .074X(X= PC20 FEV1 ,Y= FeNO) .Conclusion FeNO is a reliable indicator to evaluate the control situation of non‐specific inflammation in asthmatic children .Combined with bronchial provocation test ,the diag‐nosis rate of asthma in clinical remission stage will significantly raised .

11.
Chinese Journal of Digestion ; (12): 811-816, 2014.
Article in Chinese | WPRIM | ID: wpr-469270

ABSTRACT

Objective To explore the efficacy and safety of infliximab (IFX) treatment in inducing and maintaining deep remission (DR) in patients with moderate to severe Crohn's disease (CD).Methods From February 2012 to April 2014,the clinical data of 26 patients with moderate to severe CD received IFX treatment were retrospectively analyzed.Laboratory indexes (erythrocyte sedimentation rate (ESR),C-reactive protein (CRP),albumin),Crohn's disease activity index (CDAI),Crohn's disease simplified endoscopic score (SES-CD),rate of DR and side effects were observed before treatment,at week 14 and week 30.The t test was performed for normal distribution measurement data comparison between two groups.Wilcoxon signed rank test was performed for non normal distribution measurement data comparison between two groups.Chi square test and Fisher exact probability method were used for rate comparison.Results In 26 patients with CD,at week 14,the CDAI significantly decreased compared with that before treatment (225.0(124.0,265.0) vs 80.0(67.0,124.7),Z=-4.265,P<0.01); ESR and CRP levels also significantly decreased while body mass index (BMI) and albumin levels increased.The rate of clinical remission,mucosal healing under endoscope and DR was 80.0 % (21/26),42.3 % (11/ 26) and 34.6% (9/26),respectively.The rate of clinical remission was higher in patients with the disease course less than one year (92.3% vs 69.2%,P=0.32).At week 30,the CDAI of patients significantly decreased compared with that before treatment (225.0(124.0,265.0) vs 81.5(67.0,111.0),Z=-4.877,P<0.01); the ESR and CRP levels significantly decreased; while the BMI and albumin levels increased.The rate of clinical remission,mucosal healing under endoscope and DR was 88.5 % (23/26),57.7%(15/26) and 53.8% (14/26),respectively.Rate of clinical remission was higher in patients with the disease course less than one year (100.0% vs 76.9%,P=0.22).The differences in the rates of clinical remission,mucosal healing and DR between week 14 and week 30 were not statistically significant.Conclusion IFX could induce and maintain DR in patients with moderate to severe CD.

12.
Allergy, Asthma & Respiratory Disease ; : 11-19, 2013.
Article in Korean | WPRIM | ID: wpr-122737

ABSTRACT

Asthma is a heterogeneous disorder with a variable course, characterized by episodes of cough, wheezing and shortness of breath, reversible airflow limitation, and bronchial hyperresponsiveness (BHR). It begins early in life in many subjects, and it is well recognized that over 50% of asthmatic children go into long-term clinical remission, defined as the complete absence of asthmatic symptoms and no asthma medication for at least 24 months, during adolescence. Several studies have shown spirometric abnormalities and BHR during clinical remission. It is unknown whether these functional abnormalities, which are supposed to be indicative of asthma severity with respect to symptomatic asthma, reflect persistent airway inflammation or merely indicate residual airway damage or are related to another mechanism such as a familial predisposition. It is likely that the nature of BHR in asthma remission is not same as that in symptomatic asthma. We have shown that the former condition is associated with lower levels of blood eosinophils and eosinophilic cationic protein, a lower degree of bronchial responsiveness to exercise, and a more common formation of plateau on the dose-response curve to high-dose inhaled methacholine (i.e., limited maximal airway narrowing), compared to the latter condition. It is still controversial whether BHR in adolescents with asthma remission is reduced by inhaled corticosteroids. Better understanding of the mechanisms that lead to asthma remission, especially that seen during adolescence, is likely to lead to significant advances in our understanding of asthma pathogenesis, and should provide insights into how remission might be induced with therapy. We still have minimal understanding of the mechanism underlying BHR in adolescents with asthma remission. Elucidation of this mechanism would be an important step towards new perspectives that see remission as the next therapeutic frontier in asthma.


Subject(s)
Adolescent , Child , Humans , Adrenal Cortex Hormones , Asthma , Cough , Dyspnea , Eosinophils , Inflammation , Methacholine Chloride , Respiratory Sounds
13.
Korean Journal of Pediatrics ; : 556-564, 2007.
Article in Korean | WPRIM | ID: wpr-196110

ABSTRACT

PURPOSE: We hypothesized that the persisting bronchial hyperresponsiveness (BHR) of adolescents with asthma remission may be controlled mainly by genetic factors, and the BHR of symptomatic asthma by airway inflammation. beta2-adrenoceptor gene is considered to be a candidate gene in the development of BHR. Thus, beta2-adrenoceptor gene polymorphism may be associated with the BHR of adolescents with asthma remission, but not with the BHR of symptomatic asthma. To evaluate this hypothesis, beta2-adrenoceptor gene polymorphism at 2 sites (Arg16-Gly, Gln27-Glu) were examined. METHODS: Two hundred two adolescents with BHR (PC20<18 mg/mL) and long term remission (neither asthma-related symptoms nor medication during the previous 2 years) of their asthma (remission group), 182 adolescents with symptomatic asthma (symptomatic group), and 200 healthy adolescents (control group) were studied. Asthma phenotypes were determined using methacholine bronchial provocation test and skin prick test. Genotypes of beta2-adrenoceptor polymorphism were evaluated by PCR-based methods. RESULTS: Gly/Gly allele and Gly16-Gln27 haplotype were more prevalent in the remission group than in the control group (P=0.01, P=0.02), although there was no difference between the symptomatic group and the control group. In the remission group, there was significant difference in geometric mean of PC20 among the 3 groups subdivided by the number of Gly16-Gln27 haplotype, showing that the Gly16-Gln27 haplotype was positively associated with BHR. However, no association was found between Gly16-Gln27 haplotype and BHR in the symptomatic group. CONCLUSION: This study demonstrates that beta2-adrenoceptor polymorphism at amino acid 16 and 27 was associated with BHR persisting in adolescents with asthma remission.


Subject(s)
Adolescent , Humans , Alleles , Asthma , Bronchial Provocation Tests , Genotype , Haplotypes , Inflammation , Methacholine Chloride , Phenotype , Polymorphism, Genetic , Skin
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