Glucocorticosteroids Inflammation and Bronchial Hyperreactivity [antikvár]

Introduction Bronchial hyperreactivity is generally considered to be of fundamental importance in bronchial asthma. It has been defined as an increased sensitivity of the airways to various triggers which result in airflow limitation. Subjects having bronchial hyperreactivity are known to develop a greater degree of constriction of their airways after exposure to a number of stimuli than do subjects with normál bronchial responsiveness. There seems to be a close relationship between bronchial hyperreactivity and asthma, since a change in bronchial hyperreactivity is very often parallelled by a change in asthma. Studies have, however, shown that bronchial hyperreactivity is present not only in asthma but alsó in a number of other respiratory conditions such as chronic bronchitis, cystic fibrosis, sarcoidosis (see review by R. Ellul-Micallef, page 75). This appears to indicate that the relationship between bronchial hyperreactivity and asthma is not necessarily a direct cause-effect affair but that both may be the result of somé more fundamental abnormality, e.g. inflammation. If so, the greater degree of bronchial hyperreactivity seen in asthma, when compared to that found in other bronchopulmonary conditions, may suggest that the inflammation present in asthmatic airways is 'special' in somé way (see review by J.C. Hogg, page 3, and P. Venge, page 21). The aim of this symposium was to review our present knowledge of bronchial hyperreactivity and to present somé new findings regarding the mechanisms of inflammation in the airways and the relationship between inflammation and bronchial hyperreactivity. If airway inflammation triggers bronchial hyperreactivity and asthma, both may be counteracted by treatment with anti-inflammatory agents, e.g. glucocorticosteroids. It is widely accepted that glucocorticosteroids are effective drugs in the control of asthma, but there is little information regarding their effect on bronchial hyperreactivity. This symposium presents further experimentál and clinical work on the effect of drugs, mainly budesonide, on bronchial hyperreactivity. The interpretation of drug effects on bronchial hyperreactivity is recognized to be difficult if there has been a change in baseline respiratory function during therapy. In attempting to circumvent this problem the clinical studies were performed in asthmatic patients with normál, or close to normál, lung func-