The Journal of allergy and clinical immunology
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J. Allergy Clin. Immunol. · Mar 2006
Randomized Controlled Trial Multicenter Study Comparative StudyAsthma control can be maintained when fluticasone propionate/salmeterol in a single inhaler is stepped down.
Asthma control is the goal of treatment, but little data exist to support treatment strategies for stepping down treatment once control has been achieved. ⋯ In patients achieving asthma control with FSC 250/50 microg twice daily, stepping treatment down to a lower dose of FSC 100/50 microg twice daily is more effective than switching to an inhaled corticosteroid alone.
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J. Allergy Clin. Immunol. · Oct 2005
Randomized Controlled Trial Clinical TrialEffect of IVL745, a VLA-4 antagonist, on allergen-induced bronchoconstriction in patients with asthma.
Very late antigen (VLA-4) antagonists have been proposed as potential therapies for diseases in which cell recruitment and accumulation are causative. Asthma, which is characterized by airway inflammation involving the accumulation of eosinophils and mononuclear cells, is one such disease. ⋯ In patients with mild-to-moderate atopic asthma, IVL745 did not affect the early and late response to inhaled allergen or markers of airway inflammation, except for a modest reduction in sputum eosinophils.
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J. Allergy Clin. Immunol. · Jul 2005
Randomized Controlled Trial Clinical TrialIL-9 and c-Kit+ mast cells in allergic rhinitis during seasonal allergen exposure: effect of immunotherapy.
Background IL-9 is an important stimulus for tissue infiltration by mast cells, a feature requiring concomitant activation of c-Kit. Objectives We assessed IL-9 expression and c-Kit + mast cells in the nasal mucosa of patients with allergic rhinitis during seasonal pollen exposure and observed the effects of allergen immunotherapy. Methods We studied 44 patients with seasonal rhinitis and asthma before and 2 years after a double-blind trial of grass pollen immunotherapy. ⋯ Conclusion IL-9 is upregulated in the nasal mucosa during the pollen season and correlates with tissue infiltration by eosinophils. Successful pollen immunotherapy is associated with inhibition of seasonal increases in both nasal c-Kit + mast cells and eosinophils. This effect might be explained, at least in part, by the reduced local expression of IL-9.
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J. Allergy Clin. Immunol. · Apr 2005
Randomized Controlled Trial Clinical TrialSputum eosinophil counts predict asthma control after discontinuation of inhaled corticosteroids.
Although inhaled corticosteroids (ICSs) are effective in preventing deterioration in asthma control, at least half of subjects with mild-to-moderate asthma will remain stable when these agents are discontinued. ⋯ On the basis of a model treatment strategy, we estimate that allocating subjects to ICS therapy on the basis of changes in sputum eosinophil counts after a trial discontinuation could allow 48% of subjects with mild-to-moderate asthma to discontinue ICS therapy without an increased risk of asthma deterioration over a period of at least 14 weeks.
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J. Allergy Clin. Immunol. · Oct 2004
Randomized Controlled Trial Multicenter Study Clinical TrialCoseasonal sublingual immunotherapy reduces the development of asthma in children with allergic rhinoconjunctivitis.
We wondered whether short-term coseasonal sublingual immunotherapy (SLIT) can reduce the development of asthma in children with hay fever in an open randomized study. ⋯ Three years of coseasonal SLIT improves seasonal allergic rhinitis symptoms and reduces the development of seasonal asthma in children with hay fever.