A Study Of T Lymphocytes In Patients With Bronchial Asthma Treated With Inhaled Corticosteroids Plus Theophylline.

ObjectiveLung Asthma is a common respiratory disorder in China. Despite significant improvement in the diagnosis and management of this disorder, the majority of Chinese with asthma remain poorly controlled. Only 0.3% of Chinese with asthma have controlled the desease under therapeutic guideline recommendations from the Global Initiative for Asthma(GINA).In most patients, however, control can be achieved through the use of avoidance measures and appropriate pharmacological interventions. Inhaled corticosteroids(ICSs) represent the standard of care for the majority of patients. Combination ICS/long-acting beta2-agonists(LABA) inhalers are preferred for most adults who fail to achieve control with ICS therapy.This study was to investigate the therapeutic effects of ICS plus low-dose Aminophyllinum for moderate bronchial Asthma and the therapeutic effect of low-dose inhaled corticosteroids plus low-dose Aminophyllinum to the smokers with moderate bronchial asthma. Furthermore, the therapeutic effects of ICS plus low-dose Aminophyllinumon the percents of Th1, Th2, Th17 cells were explored, and relationship of the percents of Th1, Th2, Th17 cells and lung function and the airway inflammation of the asthmatics were investigated.Methods1 To screen 25 moderate bronchial asthma cases in the clinic, and they accepted inhalation budesonide 400μg·d-1 plus Aminophyllinumon tablet(0.1g tid po), Thecourse of treatment was about 3 months. The forced expiratory volume in one second % predicted(FEV1 % predicted), the percents of Th1, Th2, Th17 cells of peripheral blood and IL-4, IL-5,Ig E of peripheral blood were compared before and after treatment.2 280 asthma patients were randomly divided into treatment group and control group. Patients in treatment group accepted inhalation budesonide 400μg/d and Aminophyllinumon tablet 0.1 tid po. Patients in control group accepted inhalation budesonide 320μg/d and formoterol 9μg/d. Fe NO, sputum eosinophils, PEF and ACT scores were compared between two groups.3 To screen 80 bronchial asthma cases in the clinic, and they were randomized to two groups: the observed group and the control group. The observed group consisted of smokers and the observed group consisted of non-smokers. They all accepted inhalation budesonide 400μg·d-1 plus Aminophyllinumon tablet(0.1g tid po) for 3 months. The ACT, PEF, FEV1 % predicted, IL-4,IL-5 and Ig E of peripheral blood were compared before and after treatment.4 Statistical analysis:Data are expressed as means ± SD. Statistical analysis was performed using the SPSS software version 16.0. All the data were analyzed by ANOVA. P < 0.05 was considered statistically significant.Results1 ICS plus low-dose Aminophyllinum can reduce the percents of Th2, Th17 cells, and the percents of Th2, Th17 cells were positively related to lung function and the airway inflammation of the asthmatics.2 After 1 month, ameliorate of PEF and ACT scores in budesonide/ Aminophyllinum group was inferior to that in inhalation budesonide and formoterol group(P<0.05), whereas that of sputum eosinophils were better(P<0.05). There was no significant difference about Fe NO between two groups(P>0.05). After 3 month, ameliorate of sputum eosinophils in treatment group were better than that in control group(P<0.05), whereas there was no significant difference about PEF, ACT scores and Fe NO between two groups(P>0.05). Both of the two groups can reduce the percents of Th2, Th17 cells. There were no differences between two groups(P>0.05).3 Before and 3 months after the treatment, the ACT, PEF, FEV1 % predicted, IL-4,IL-5, Ig E value for the observed group consisted of smokers were(12.2±3.3) and(18.3±2.9),(255.9±99.7)L·min-1 and(290.3±105.2)L·min-1,(66.5±4.7) and(72.9±5.4),(14.5±3.2) pg·m L-1 and(12.3±3.4) pg·m L-1,(27.2±6.4) pg·m L-1 and(24.2±5.8) pg·m L-1,(82.7±16.8) IU·ml-1 and(67.1±14.3) IU·ml-1, respectively, and those for the control group consisted of non-smokers were(13.0±3.4) and(19.1±2.6),(279.1±103.3)L·min-1 and(321.3±110.4)L·min-1,(68.8±5.8) and(74.8±5.5),(13.4±2.9) pg·ml-1 and(11.4±2.8) pg·ml-1,(26.5±6.9) pg·ml-1 and(22.8±6.2) pg·ml-1,(78.8±18.2) IU·ml-1 and(66.4±17.8) IU·ml-1, respectively, which were remarkably improved in both groups(P<0.05). Both of the two groups can reduce the percents of Th2, Th17 cells. There were no differences between two groups(P>0.05).Conclusions: Compared with non-smokers, the smokers with moderate bronchial asthma treated with ICS plus low-dose Aminophyllinum showed similar therapeutic effects in the improvement of clinical symptoms, increasing of lung function and control of the airway inflammation.