Short- and medium-term effect of inhaled corticosteroids on exhaled breath biomarkers in severe asthma
Inhaled corticosteroids (ICS) are the mainstay of therapy in asthma, but benefits vary due to
disease heterogeneity. Steroid insensitivity is a particular problem in severe asthma, where
patients may require systemic corticosteroids and/or biologics. Biomarkers sensitive to ICS over a
short period of time could inform earlier and more personalised treatment choices. To investigate
how exhaled breath biomarkers change over two-hours and one-week following monitored ICS dosing in
severe asthma patients with evidence of uncontrolled airway inflammation. Patients with severe
asthma and elevated fractional exhaled nitric oxide (FeNO) ( ⩾45 ppb, indicative of active airway
inflammation) were recruited. Exhaled breath biomarkers were evaluated using (FeNO), exhaled breath
temperature (EBT), particles in exhaled air (PExA) and volatile organic compounds (VOCs). Samples
were collected over 2 h following observed inhalation of 1000 mcg fluticasone propionate, and at a
second visit 1 week after taking the same dose daily via an inhaler monitoring device that recorded
correct actuation and inhalation. Changes in parameters over 2 h were analysed by the Friedman test
and 1 week by Wilcoxon's test ( p -value for significance set at 0.05; for VOCs false discovery rate
q of 0.1 by Benjamini –Hochberg method applied). 17 participants (9 male) were recruited, but three
could not complete PExA and two FeNO testing, as they were unable to comply with the necessary
technique; c...
Source: Journal of Breath Research - Category: Respiratory Medicine Authors: Fahad H Alahmadi, Max Wilkinson, Brian Keevil, Rob Niven and Stephen J Fowler Source Type: research