Avtor/Urednik		Turel, Matjaž; Šuškovič, Stanislav; Pohl, Wolfgang
Naslov		Eoziofilni kationski protein pri bolnikih z astmo zdravljenih s ciklosporinom
Prevedeni naslov		The eosinophilic cationic protein in patients with asthma treated with the cyclosporine
Tip		članek
Vir		Zdrav Vestn
Vol. in št.		Letnik 65, št. Suppl 2
Leto izdaje		1996
Obseg		str. II-19-22
Jezik		slo
Abstrakt		Background. Asthma is a chronic inflammatory airway disease in which many cells including eosinophils play a role in pathogenesis. Corticosteroids in inhalation are currently the most effective anti-inflammatory drugs for the treatment of astbma. The main goal in the systemic steroid dependent asthmatics (SDA) is to reduce steroid side effects by using other effective antiinflammatory drug. Cyclosporine A is an immunosupresive drug with potentially beneficial effect on airways inflammation. The main goal of this study was to investigate if low doses one week treatment with CyA influenced eosinophilic cationic protein (ECP) and airway obstruction. Patients and methods. Twelve SDA (group A) were treated with CyA (2mg/kg/day) for one week. Eight asthmatics who didn't regularly use systemic corticosteoids (group B) were treated with 40 mg methyleprednisolone (MDA) daily. Eight healthy atopics without history of asthma (group C) was the second control group. In groups A and B blood samples were collected every four hours the day before and the last day of the treatment. Corresponding measurements in the group C were performed only one day. In the group A also peak expiratory flow rate (PEF) was measured together with blood concentration of yhe CyA. Results. In the group A ECP concentration and PEF did not change significantly during the treatment with CyA. No corelations between blood concentration of the CyA and serum ECP concentration or PEF were demonstrated. In the group B statistically significant (p<0.05) differences in the serum ECP before and after the treatment with MDA (at4PM, 8PM and 4AM) were found. Conclusions. We conclude that short treatment with the low doses of CyA is not likely to influence serum ECP concentrations and the degree of airway obstruction. Low doses of the CyA are therefore not likely to significantly decreased production and release of the lymphokines, which are responsible for the proliferation and activation of the eosinophils.
Izvleček		Izhodišča. Vnetje dihalnih poti s pomembnim deležem eozinofilnih granulocitov je glavna patofiziološka značilnost astme. Zdravilo izbora za zdravljenje vnetja pri astmi so inhalacijski kortikosteroidi. Za bolnike, ki so trajno odvisni od zdralvjenja s sistemskimi steroidi (SDA), poskušajo najti ustreznejše protivnetno zdravilo. Eno od takih zdravil naj bi bil imunosupresivno zdravilo ciklosporin A (CyA). Skušali smo ugotoviti ali kratkotrajno zdravljenje z nizkimi odmerki CyA vpliva na serumsko koncentracijo eoziofilnega kationskega proteina (ECP), ki ga sproščajo aktivirani eozinofilni granulociti, in na prehodnost dihalnih poti.Preiskovanci in metode. S CyA (2mg/kg telesne teže/dan) smo zdravili 12 bolnikov s SDA (skupina A). Primerjali smo jih s skupino 8 bolnikov z astmo (skupina B), ki vsaj 7 dni pred raziskavo niso prejemali sistemskih kortikosteroidov in smo jih med raziskavo zdravili s 40 mg metilprednizolona (MDA) dnevno (skupina B). Drugo kontrolno skupino je predstavljalo 8 zdravih atopikov brez kliničnih znakov astme (skupina C). V skupini A in B smo dan pred in zadnji dan zdravljenja vsake štiri ure določali serumsko koncentracijo ECP, v skupini C le na dan raziskave. V skupini A smo ob istih urah merili tudi največji pretok zraka med forsiranim izdihom (PEF) in koncentracijo CyA v krvi. Rezultati. V skupini A CyA ni statistično pomembno vplival na serumsko koncentracijo ECP in PEF. Nismo našli povezav med koncentracijo CyA v krvi in serumsko koncentracijo ECP ali PEF. V skupini B smo našli statistično pomembne (p<0,05) razlike v serumski koncentraciji ECP (ob 16., 20. in 4. uri) pred in po zdravljenju z MDA. Zaključki. Zaključujemo, da kratkotrajno zdravljenje bolnikov s SDA z nizkimi odmerki CyA ne vpliva na serumsko koncentracijo ECP in prehodnost dihalnih poti. CyA v nizkih odmerkih verjetno pomembno ne zavira izločanja nekaterih limfokinov, ki so odgovorni za proliferacijo in aktivacijo eozinofilnih granulocitov.
Deskriptorji		ASTHMA CYCLOSPORINE BLOOD PROTEINS EOSINOPHILS PEAK EXPIRATORY FLOW RATE METHYLPREDNISOLONE