Airway inflammation in asthma : from concept to the clinic

Rensen, E.L.J. van

Three aspects of airway inflammation in asthma were investigated in this thesis: proof of concept, monitoring and management. In chapter 2 is shown that IL-5 is mainly effective in the circulation. In chapter 3 is shown that steroids improve airway hyperresponsiveness, sputum eosinophils, and NO. The changes were not related. This suggests that these markers may provide different information when monitoring anti-inflammatory treatment in asthma. In chapter 4 is shown that alpha-2-macroglobulin is an appropriate marker for measuring microvascular leakage in sputum. This "dual induction" model may used when testing the antiexudative effect of drugs. Chapter 5 demonstrated that the annual decline in FEV1 is related with CD8+ cells. This suggests that inflammatory phenotypes in asthma may have prognostic relevance. In chapter 6 is shown that PEF-variability provides information about asthma severity. Therefore, the current guidelines for the treatment of asthma can be improved by...Show moreThree aspects of airway inflammation in asthma were investigated in this thesis: proof of concept, monitoring and management. In chapter 2 is shown that IL-5 is mainly effective in the circulation. In chapter 3 is shown that steroids improve airway hyperresponsiveness, sputum eosinophils, and NO. The changes were not related. This suggests that these markers may provide different information when monitoring anti-inflammatory treatment in asthma. In chapter 4 is shown that alpha-2-macroglobulin is an appropriate marker for measuring microvascular leakage in sputum. This "dual induction" model may used when testing the antiexudative effect of drugs. Chapter 5 demonstrated that the annual decline in FEV1 is related with CD8+ cells. This suggests that inflammatory phenotypes in asthma may have prognostic relevance. In chapter 6 is shown that PEF-variability provides information about asthma severity. Therefore, the current guidelines for the treatment of asthma can be improved by including PEF-variability. In chapter 7 is shown that anti-IgE improves PEF, diminishes allergen responses and is paralleled by a reduction in eosinophils in biopsies and sputum and a decline in IgE+ cells. This suggests that the clinical benefits of anti-IgE in asthma may be explained by a decrease in eosinophilic inflammation and IgE bearing cells.Show less

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Airway inflammation in asthma : from concept to the clinic

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