pulmicort and Ischemia

Topics: Acute Chest Syndrome; Acute Pain; Administration, Inhalation; Anemia, Sickle Cell; Anti-Inflammatory Agents; Budesonide; Child, Preschool; Feasibility Studies; Female; Hospitalization; Humans; Infant; Ischemia; Male; Parents; Patient Acceptance of Health Care; Quality of Life; Recurrence; Treatment Outcome

Epidemiological studies have indicated that chronic obstructive pulmonary disease (COPD) may be associated with an increased incidence of ischaemic cardiac events. The current authors performed a post hoc analysis of the European Respiratory Society's study on Chronic Obstructive Pulmonary Disease (EUROSCOP); a 3-yr, placebo-controlled study of an inhaled corticosteroid budesonide 800 microg.day(-1) in smokers (mean age 52 yrs) with mild COPD. The current study evaluates whether long-term budesonide treatment attenuates the incidence of ischaemic cardiac events, including angina pectoris, myocardial infarction, coronary artery disorder and myocardial ischaemia. Among the 1,175 patients evaluated for safety, 49 (4.2%) patients experienced 60 ischaemic cardiac events. Patients treated with budesonide had a significantly lower incidence of ischaemic cardiac events (18 out of 593; 3.0%) than those receiving placebo (31 out of 582; 5.3%). The results of the present study support the hypothesis that treatment with inhaled budesonide reduces ischaemic cardiac events in patients with mild chronic obstructive pulmonary disease.

Topics: Administration, Inhalation; Adrenal Cortex Hormones; Bronchodilator Agents; Budesonide; Dose-Response Relationship, Drug; Female; Humans; Inhalation; Ischemia; Male; Placebos; Prognosis; Pulmonary Disease, Chronic Obstructive; Randomized Controlled Trials as Topic; Smoking

A temporary ischaemia with total circulatory arrest of the hamster cheek pouch was obtained by clamping the neck of the everted cheek pouch. The macromolecular permeability increase in postcapillary venules was quantified as the leakage of fluorescein-labelled dextran using intravital microscopy and a fluorometer simultaneously. At reperfusion after 30 min ischaemia, there was a significant and reversible permeability increase. This response could be totally prevented by topical administration of either terbutaline, a selective beta 2-receptor agonist, or budesonide, a glucocorticoid, but it was not significantly impeded by the antihistamine mepyramine. The study shows that, in conformity with the situation in inflammation, the postischaemic permeability increase at reperfusion after ischaemia can be blocked by either beta 2-stimulation or glucocorticoids. Furthermore, it indicates that histamine, a common inflammatory mediator, is not responsible for the postischaemic permeability increase.

Topics: Animals; Budesonide; Capillary Permeability; Cheek; Cricetinae; Ischemia; Macromolecular Substances; Male; Mesocricetus; Pregnenediones; Pyrilamine; Terbutaline