pulmicort and Dermatitis--Atopic

Topics: Asthma; Biomarkers; Bronchodilator Agents; Budesonide; Child, Preschool; Dermatitis, Atopic; Dipeptidyl Peptidase 4; Eczema; Humans; Infant; Ki-1 Antigen; Lung; Respiratory Function Tests; Th1 Cells; Th1-Th2 Balance; Th2 Cells

Vitamin D is hypothesized to have some roles in innate and adaptive immunity, inflammation reduction, and remodeling; therefore, it is supposed to affect the asthma phenotype, severity, and response to inhaled corticosteroid (ICS).. To explore the synergistic effects of vitamin D supplementation in addition to asthma controllers (ICS or ICS plus long-acting β-agonist) on airway functions.. A randomized clinical trial was conducted in 130 individuals aged 10 to 50 years who lived in Tehran during a 24-week period. Data on age, sex, body mass index, stage of asthma, serum total IgE, history of allergic rhinitis, atopic dermatitis, food allergy, and urticaria were collected. Spirometric parameters (forced expiratory volume in 1 second [FEV1] and ratio of FEV1 to forced vital capacity) and serum vitamin D measurement were obtained before and 8 and 24 weeks after the intervention. Patients were divided in 2 groups randomly. Both groups received asthma controllers (budesonide or budesonide plus formoterol) according to their stage, but the intervention group received vitamin D supplementation (100,000-U bolus intramuscularly plus 50,000 U orally weekly) in addition to asthma controllers.. FEV1 improved significantly in both groups after 8 weeks, but no significant difference was found between the 2 groups at baseline (P = .20) or after 8 weeks (P = .99); however, a significant improvement was seen in the intervention group in the last 16 weeks, and FEV1 was significantly better in the intervention group than the other group after 24 weeks (P < .001).. Vitamin D supplementation associated with asthma controllers could significantly improve FEV1 in mild to moderate persistent asthma after 24 weeks.. irct.ir Identifier: IRCT201302079608N1.

Topics: Adolescent; Adult; Anti-Inflammatory Agents; Asthma; Bronchodilator Agents; Budesonide; Child; Dermatitis, Atopic; Dietary Supplements; Drug Synergism; Ethanolamines; Female; Food Hypersensitivity; Forced Expiratory Volume; Formoterol Fumarate; Humans; Immunoglobulin E; Iran; Male; Middle Aged; Prospective Studies; Rhinitis, Allergic; Urticaria; Vital Capacity; Vitamin D; Young Adult

Topics: Administration, Inhalation; Breath Tests; Budesonide; Child; Child, Preschool; Dermatitis, Atopic; Exhalation; Female; Humans; Lung; Male; Nebulizers and Vaporizers; Nitric Oxide; Prospective Studies

A randomized, blinded, placebo-controlled study was conducted to assess the efficacy of a new 0.025% budesonide leave-on-conditioner (Barazone) in controlling the clinical signs of canine atopic dermatitis (AD). Twenty-nine dogs with AD were randomly allocated to receive 3 weeks of once-weekly treatment with either Barazone or Placebo and then were crossed-over to receive the alternative treatment for a further 3 weeks. At the start and end of each treatment phase, referring veterinarians performed a dermatological and general physical examination on each dog, assigned a Lesional Score, collected blood for haematological and biochemical analyses and rated the dog's overall tolerance to the preceding treatment. Owners assessed their dog's level of pruritus and quality of life (QoL) daily, using visual analogue scales labelled with behavioural descriptors. Barazone improved skin lesions (P = 0.02) and QoL (P < 0.001) and reduced pruritus (P ≤ 0.002) compared with treatment with Placebo. There were no significant differences in the tolerance scores and only minor differences in the general physical examination findings and haematological and biochemical parameters between dogs receiving Barazone or Placebo. This study demonstrated that Barazone, applied once weekly at 1 g/kg for 3 weeks, was an efficacious treatment for the control of the clinical signs of AD in dogs.

Topics: Administration, Topical; Animals; Antipruritics; Budesonide; Cross-Over Studies; Dermatitis, Atopic; Dog Diseases; Dogs; Female; Glucocorticoids; Male; Pruritus; Single-Blind Method; Skin

To evaluate the influence of early antiinflammatory therapy in the development of asthma 3 years after hospitalization for wheezing in infancy. In addition, the effects of allergic sensitization and respiratory syncytial virus (RSV) infection on the development of asthma were investigated.. A randomized, controlled follow-up study in a university hospital that provides primary hospital care for all pediatric patients in a defined area.. Eighty-nine infants under 2 years of age who had been hospitalized for infection associated with wheezing and followed up for 3 years.. Early antiinflammatory therapy was given for 16 weeks; 29 patients received cromolyn sodium and 31 received budesonide. Twenty-nine control patients received no therapy.. Clinical diagnosis of current asthma, defined as having at least 3 episodes of physician-diagnosed wheezing and either a wheezing episode during the preceding year or ongoing antiinflammatory medication for asthma.. Fourteen (48%) patients in the former cromolyn group, 15 (48%) in the former budesonide group, and 16 (55%) in the control group had current asthma. The significant predictors of asthma were age over 12 months (risk ratio [RR] 4.1; 95% confidence interval [CI] = 1.59-10.35), history of wheezing (RR 6.8; CI = 1.35-34.43), and atopic dermatitis on study entry (RR 3.4; CI = 1.17-9.39). Skin prick test positivity at the age of 16 months significantly predicted asthma (RR 9.5; CI = 2.45-36.72). In addition, all of the 18 (20%) children sensitized with furred pet developed asthma. RSV identification (RR 0.3; CI = 0.08-0.80) and early furred pet contact at home (RR 0.3; CI 0.10-0.79) were associated with the decreased occurrence of asthma.. Antiinflammatory therapy for 4 months has no influence on the occurrence of asthma 3 years after wheezing in infancy. Early sensitization to indoor allergens, especially to pets, and atopic dermatitis predict subsequent development of asthma. RSV infection in wheezing infants may have a better outcome than other infections.

Topics: Administration, Inhalation; Anti-Inflammatory Agents; Asthma; Budesonide; Comorbidity; Cromolyn Sodium; Dermatitis, Atopic; Disease Progression; Female; Finland; Follow-Up Studies; Food Hypersensitivity; Hospitalization; Humans; Infant; Male; Prospective Studies; Respiratory Hypersensitivity; Respiratory Sounds; Respiratory Syncytial Virus Infections; Risk Factors

We investigated the 1-year outcome of children hospitalized for wheezing, paying special attention to the effect of early anti-inflammatory therapy. In addition, we identified risk factors for recurrent wheezing and asthma. Eighty-eight children under 2 years old treated in the hospital for wheezing were followed for 1 year. Nebulized anti-inflammatory therapy was given for 16 weeks: 31 patients received budesonide, 29 patients cromolyn sodium, and 28 control patients received no therapy. The number of subsequent physician-diagnosed wheezing episodes was recorded. Four months of anti-inflammatory therapy did not significantly decrease the occurrence of asthma 1 year later; 45% of patients in the cromolyn group, 42% in the budesonide group, and 61% in the control group had asthma, defined as at least two bronchial obstruction episodes during the 1-year period after the original hospitalization for wheezing. An age over 12 months at the time of the initial bronchial obstructing episode [P=0.009, risk ratio (RR)=5.4, 95% confidence interval (CI)=1.53-19.31], failure to identify a viral cause (P=0.0003, RR=12.0, CI=3.16-45.40), history of wheezing (P=0.02, RR=14.6, CI=1.59-132.10), the presence of atopy (P=0.01, RR=5.3, CI=1.47-19.21), a family history of atopy (P=0.03, RR=3.6, CI =1.15-11.12), and serum eosinophil cationic protein (ECP) > or = 16 microg/L (P=0.005) were significant risk factors for asthma. We conclude that early anti-inflammatory therapy for 4 months does not significantly decrease the occurrence of asthma during the period of 1 year following hospitalization for the original episode of wheezing. Young children requiring hospital admission for wheezing during a respiratory tract infection are at increased risk of having subsequent asthma if they have wheezed previously, if they have atopy or a family history of atopy, if they have elevated serum ECP, if they are over 12 months of age at the original bronchial obstructive episode, and especially when viral studies are negative.

Topics: Administration, Inhalation; Administration, Oral; Analysis of Variance; Anti-Asthmatic Agents; Anti-Inflammatory Agents; Asthma; Bronchi; Budesonide; Chi-Square Distribution; Child, Preschool; Cromolyn Sodium; Dermatitis, Atopic; Drug Therapy, Combination; Female; Follow-Up Studies; Humans; Hypersensitivity; Infant; Infant, Newborn; Logistic Models; Male; Prospective Studies; Recurrence; Respiratory Sounds; Risk Factors; Theophylline; Time Factors

Topics: Allergens; Budesonide; Dermatitis, Allergic Contact; Dermatitis, Atopic; Humans; Patch Tests

To describe the clinical and laboratory profile, natural course, treatment outcome, and risk factors of posttransplant esophageal and nonesophageal eosinophilic gastrointestinal disorders (EGIDs).. All children (aged <18 years) who underwent liver transplantation, between 2011 and 2019, in a single transplant center with a follow-up period of 1 year or more posttransplant and with a history of posttransplant endoscopic evaluation were included in this study.. During the study period, 89 children met the inclusion criteria. Patients were followed for a median of 8.0 years. A total of 39 (44%) patients were diagnosed with EGID after transplantation. Of these, 29 (33%) had eosinophilic esophagitis (EoE), and 10 (11%) had eosinophilic gastritis, gastroenteritis or enterocolitis. In comparison with the non-EGID group, patients with EGID were younger at transplant (P ≤ 0.0001), transplanted more frequently due to biliary atresia (P ≤ 0.0001), and had higher rates of pretransplant allergy (P = 0.019). In the posttransplant period, they had higher rates of mammalian Target of Rapamycin inhibitor use (P = 0.006), Epstein-Barr virus viremia (P = 0.03), post-transplant lymphoproliferative disease (P = 0.005), and allergen sensitization (P ≤ 0.0001). In regression analysis, young age at transplant, age at diagnosis, pretransplant atopic dermatitis, and post-transplant lymphoproliferative disease were associated with an increased risk of EGID or EoE. Laboratory abnormalities such as anemia (P = 0.007), thrombocytosis (P = 0.012), and hypoalbuminemia (P = 0.031) were more commonly observed in the eosinophilic gastritis, gastroenteritis or enterocolitis group than in the EoE group. Following treatment, most patients had symptomatic resolution at 3 months and histologic resolution at 6 months postdiagnosis. Among the patients who had 5 years of follow-up, none recurred.. EGID is a common posttransplant diagnosis, which seems to affect patients who are transplanted earlier and who have pretransplant atopy. Posttransplant EGID is responsive to treatment, but as histologic remission occurs after symptomatic resolution, the decision to perform control endoscopy should be delayed.

Topics: Age Factors; Anti-Allergic Agents; Biliary Atresia; Budesonide; Child; Child, Preschool; Cholestasis, Intrahepatic; Dermatitis, Atopic; Disease Progression; Drug Tapering; Enteritis; Enterocolitis; Eosinophilia; Eosinophilic Esophagitis; Epstein-Barr Virus Infections; Female; Follow-Up Studies; Gastritis; Glucocorticoids; Graft Rejection; Humans; Hypersensitivity; Immunosuppressive Agents; Infant; Ketotifen; Liver Failure, Acute; Liver Transplantation; Lymphoproliferative Disorders; Male; Postoperative Complications; Prevalence; Retrospective Studies; Risk Factors; Tacrolimus; TOR Serine-Threonine Kinases; Treatment Outcome; Viremia

Budesonide was included in the European Baseline Series in 2000 as the most suitable marker forcorticosteroid hypersensitivity. In the last two decades, a decreasing trend of budesonide allergy has been observed.. To estimate the prevalence of positive patch test reactions to budesonide in a large, Italian patch test population, characterizing patients according to MOAHLFA index and evaluating the benefit with extended readings of budesonide patch test.. Retrospective analysis of patient demographics and patch test results over a 2-year period (2018-2019) was performed at 14 patch test clinics in Italy.. Ninety out of 14 544 (0.6%) patients reacted to budesonide 0.01% pet.. Positive reactions were mild in 54.4% and late readings at day 7 showed new positive reactions in 37.8% of patients. The MOAHLFA index showed a significant positive association with male gender, atopic dermatitis, and age >40 years and a significant negative association with hand and face dermatitis.. We documented a low prevalence of budesonide allergy in Italy, confirming its decreasing trend recently reported in the literature. Nevertheless, budesonide needs to be maintained in the baseline series for its good ability to detect corticosteroid sensitization.

Topics: Adult; Age Distribution; Aged; Budesonide; Cross Reactions; Dermatitis, Allergic Contact; Dermatitis, Atopic; Dermatitis, Occupational; Female; Humans; Italy; Male; Middle Aged; Patch Tests; Prevalence; Retrospective Studies; Sex Distribution

Corticosteroids are used to treat dermatoses, including allergic contact dermatitis, but can also cause contact allergy. The frequency of corticosteroid allergy varies between studies and is influenced by treatment traditions and availability.. To estimate the prevalence of tixocortol-21-pivalate, budesonide and hydrocortisone-17-butyrate allergy in a Danish patch test population and characterize individuals with corticosteroid allergy.. Three thousand five hundred and ninety-four patients were patch tested with tixocortol-21-pivalate, budesonide, and hydrocortisone-17-butyrate. Characterization was performed according to the MOAHLFA index and duration of disease.. Two per cent had a steroid allergy: 0.8% had a tixocortol-21-pivalate allergy, 1% a budesonide allergy, and 1% a hydrocortisone-17-butyrate allergy. Tixocortol-21-pivalate and budesonide allergy were associated with atopic dermatitis in crude analyses, but only tixocortol-21-pivalate allergy and atopic dermatitis remained associated in adjusted analyses. Leg dermatitis was uniquely associated with tixocortol-21-pivalate allergy. Hydrocortisone-17-butyrate allergy was associated with duration of disease in both crude and adjusted analyses.. Chronic dermatoses (atopic dermatitis and leg dermatitis) were identified as risk factors for group A corticosteroid allergy, probably because of more pronounced exposure to group A steroids resulting from ease of access that is exploited by patients with a chronic dermatosis. The duration of disease rather than the dermatosis itself seemed to be important for group B and D2 corticosteroid allergy.

Topics: Adult; Budesonide; Chronic Disease; Denmark; Dermatitis, Allergic Contact; Dermatitis, Atopic; Dermatitis, Occupational; Dermatologic Agents; Facial Dermatoses; Female; Hand Dermatoses; Humans; Hydrocortisone; Leg Dermatoses; Male; Middle Aged; Patch Tests; Prevalence; Risk Factors

Studies of the genetics of chronic rhinosinusitis offer potential insights into the pathophysiology of this poorly understood condition. However, genetic studies are both expensive and time consuming-hence the importance of establishing beforehand the proper population and target genes. We wished to identify patient factors associated with a proposed definition of severe chronic rhinosinusitis to minimize heterogeneity and maximize the impact of genetic contributions. We therefore wanted to determine if the response to a standardized therapy following endoscopic sinus surgery could be used as a viable phenotypic criterion for subsequent genetic studies.. Retrospective chart review.. Tertiary sinus centre.. Seventy-one cases of chronic rhinosinusitis refractory to medical and surgical treatment were studied. They formed two groups according to their response to a standardized treatment protocol. We collected information concerning patients' characteristics and bacteriology on endoscopic culture.. 60.5% patients were managed successfully with budesonide irrigations. Atopy was present in 33.8%, asthma in 69.0%, and aspirin sensitivity in 33.3%. The rate of asthma was higher in nonresponders. Bacterial colonization rates showed the presence of Staphylococcus aureus (36.4%), gram-negative rods (29.1%), and Pseudomonas aeruginosa (32.7%).. Patients with refractory chronic rhinosinusitis represent a severely diseased, more homogeneous population in which the genetic contribution(s) to disease may be maximal. Strong associations with asthma, aspirin intolerance, and atopy suggest links between these disorders. Irrigation with budesonide solution appears to be effective in management. Studies of the genetics of chronic rhinosinusitis will include genes known to be involved with both asthma and innate immunity.

Topics: Administration, Intranasal; Anti-Inflammatory Agents; Bacterial Infections; Budesonide; Chronic Disease; Dermatitis, Atopic; Female; Genetic Techniques; Humans; Male; Middle Aged; Phenotype; Retrospective Studies; Rhinitis; Sinusitis; Therapeutic Irrigation

Recent studies have shown that the pH of exhaled breath condensate (EBC) could be predictive of asthma exacerbation. Moreover, it has been documented that both allergic rhinitis and atopic dermatitis constitute risk factors for the occurrence of asthma in a progression of disease known as atopic march. The aim of our study was to establish if condensate pH could be used as a valuable mean of monitoring of asthma in atopic children. We studied 34 atopic children with acute asthma, 70 with stable asthma, 35 children with allergic rhinitis, and 17 with atopic dermatitis. Thirty healthy children were used as controls. All children underwent skin prick tests and lung function tests. Exhaled breath condensate samples were collected with a condensing device and de-aerated with argon. The pH of EBC was measured using a pH meter. Children with acute asthma were treated with inhaled steroids and bronchodilators. We found that the pH of condensate in patients with acute asthma was lower than that of patients with stable asthma, rhinitis, and controls (7.25 vs. 7.32, p < 0.05; 7.25 vs. 7.48, p < 0.02; 7.25 vs. 7.78, p < 0.0001, respectively). Patients with stable asthma, rhinitis, and eczema had also lower pH than that of controls (7.32, 7.48, and 7.44 vs. 7.78; p < 0.0001, p < 0.006, p < 0.04, respectively). Patients with acute asthma normalized their pH after treatment (7.82 vs. 7.25; p < 0.0001). Finally, patients with acute asthma showed a positive correlation between pH and lung functional parameters (forced expiratory volume in 1 s; r = 0.39, p = 0.04). Our study shows that EBC pH measurement may be a promising marker for assessing airway inflammation and monitoring response to anti-inflammatory treatment in asthmatic children. Furthermore, we report the first evidence of airways acidification in children with allergic rhinitis and atopic dermatitis. Therefore, EBC pH assessment may be useful in the evaluation of progression of the atopic march toward the development of asthma later in life. Further studies are recommended in order to confirm this indication.

Topics: Adolescent; Albuterol; Asthma; Breath Tests; Bronchodilator Agents; Budesonide; Case-Control Studies; Child; Child, Preschool; Dermatitis, Atopic; Female; Humans; Hydrogen-Ion Concentration; Male; Respiratory Function Tests; Rhinitis; Severity of Illness Index; Skin Tests

Topics: Adult; Bronchodilator Agents; Budesonide; Dermatitis, Allergic Contact; Dermatitis, Atopic; Diagnosis, Differential; Female; Humans; Nebulizers and Vaporizers; Patch Tests; Recurrence

The effect of a single dose of 320 micrograms of budesonide R on specific and non-specific bronchial response was evaluated. The study was carried out on a group of 12 patients suffering from mild allergic asthma, sensitive to Dermatophagoides pteronyssinus (D. pteronyssinus). On the first day the bronchial provocation test (BPT) with metacholine was performed, and the next day the effect of a single dose of the drug studied on bronchial response to metacholine was evaluated. On the third day sBPT with D. pteronyssinus allergen was performed. The allergen challenge could induce an early (EAR) and a late asthmatic reaction (LAR). After the BPT with the allergen, a 42 days' run-out period was required to eliminate the effects of the allergen provocation on the results of the next tests. Before the evaluation of the effect of budesonide on the allergen challenge, the non-specific response to metacholine was checked again. The results indicate that a single dose of budesonide R does not affect non-specific and specific bronchial response.

Topics: Adult; Asthma; Bronchi; Bronchial Provocation Tests; Budesonide; Dermatitis, Atopic; Dose-Response Relationship, Drug; Female; Glucocorticoids; Humans; Male

The purpose of the study was to determine whether regular administration of budesonide R decreases inflammation, specific and non-specific bronchial hyperreactivity in allergic asthma patients. The studies were carried out on 16 patients suffering from mild to moderate allergic asthma, sensitive to D. pteronyssinus allergen. After performance of the specific and non-specific bronchial provocation tests, collection of blood samples for an ECP evaluation, the patients were regularly treated with budesonide R, 2 x 320 micrograms for a period of 8 weeks. At the end of the study the BPTs and blood collection were repeated. BPTs with methacholine and D. pteronyssinus were performed according to Ryan's method. After the allergen challenge, early (EAR) and late asthmatic reaction (LAR) were to be observed. After the therapy non-specific BHR to methacholine expressed as PC20FEV1 and specific BHR to allergen (PD20FEV1D. pteronyssinus) and serum ECP concentrations decreased significantly. Although after the treatment with budesonide R, the patients had to inhale much larger amounts of allergen, in order to induce EAR, the number of LAR did not change significantly. After treatment the LAR appeared about 1 hour later and the decrease in FEV1 was less than previously. We conclude that budesonide R decreases the intensity of the inflammation and BHR.

Topics: Adult; Asthma; Bronchi; Bronchial Provocation Tests; Budesonide; Dermatitis, Atopic; Female; Humans; Male; Respiration

Topical glucocorticosteroids are widely used in the treatment of children with atopic dermatitis. Due to percutaneous absorption, these agents may become systemically available and cause inhibition of growth in children. However, the mechanisms responsible for the growth-suppressive effective are not fully understood.. To evaluate whether treatment with topical budesonide has any adverse effects on growth-hormone-dependent serum levels of insulin-like growth factor I (IGF-I) and insulin-like growth factor binding protein 3 (IGFBP-3), and on the serum markers of bone and collagen turnover osteocalcin, the carboxy-terminal propeptide of type I collagen (PICP), the carboxy-terminal pyridinoline cross-linked telopeptide of type I collagen (ICTP) and the amino-terminal propeptide of type III procollagen (PIIINP).. 13 children (mean age 9.5 years) with atopic dermatitis were studied in an open longitudinal trial with run-in and budesonide treatment periods of 2 weeks' duration. During the run-in, only emollient was used. During the treatment period, budesonide cream 0.025% followed by emollient were applied twice daily all over the body except on the face. At day 14 of each period, blood samples were taken and eczema was scored according to a severity index based on extent and activity of the disease.. Compared to the run-in, budesonide treatment was associated with a statistically significant reduction in mean severity index (p = 0.002). No statistically significant effects on serum levels of IGF-I, IGFBP-3, osteocalcin or ICTP were observed. The serum concentrations of PICP and PIIINP were reduced with (mean +/- 1 SD) 43 +/- 64 milligrams (95% confidence interval 3.5-80 milligrams, p = 0.03, t = 2.4, d.f. = 12) and 1.2 +/- 1.5 milligrams (95% confidence interval 0.3-2.1 milligrams, p = 0.01, t = 3.0, d.f. = 12), respectively.. Type I and III collagen turnover may be suppressed during short-term treatment with topical budesonide in children with atopic eczema. clinical implications need further study.

Topics: Administration, Topical; Anti-Inflammatory Agents; Biomarkers; Bone and Bones; Budesonide; Child; Child, Preschool; Collagen; Collagen Type I; Dermatitis, Atopic; Female; Glucocorticoids; Humans; Insulin-Like Growth Factor Binding Protein 3; Insulin-Like Growth Factor I; Longitudinal Studies; Male; Osteocalcin; Peptide Fragments; Peptides; Pregnenediones; Procollagen