Tracheobronchopathy from Inhaled Corticosteroids.

Tracheobronchopathy from Inhaled Corticosteroids. Chest. 2017 Aug 29;: Authors: Husta BC, Raoof S, Erzurum S, Mehta AC Abstract In the 21(st) century inhaled corticosteroids (ICS) have become the mainstay of asthma control. Similarly, ICS are recommended as an add-on therapy to long-acting beta agonists and anti-cholinergics in moderate to severe chronic obstructive pulmonary disease (COPD) with recurrent exacerbations. Ultimately this clinical practice has led to widespread use of ICS, supported by a more favorable side effect profile than that of systemic steroids. However, high doses of ICS and the prolonged duration of the therapy may affect the airways adversely. What is considered to be a "high dose" may vary depending on the particular steroid preparation being used; therefore, defining a single dose value becomes challenging. Despite several investigations focusing on the systemic effects of this class of medications, airway complications have been under recognized. For example, ICS therapy decreases the size of the vascular component of the airway wall and may reduce the volume of blood distributed, potentially resulting in the smooth muscle weakness. Concurrently with the increased popularity of bronchoscopy and availability of advanced airway imaging, weakness in the walls of large airways, such as tracheobrochomalacia and excessive dynamic airway collapse, is being observed with increasing frequency. The authors postulate...
Source: Chest - Category: Respiratory Medicine Authors: Tags: Chest Source Type: research