ABSTRACT

Objective:

Bronchial asthma is characterized by airway inflammation, mucus hypersecretion and impaired mucociliary clearance (MCC). In vivo mucociliary clearance rates can be measured by following the rate of degress of radiolabeled marked cumulant, by gamma camera. Inhaled steroids have been shown to enhance mucociliary clearance rates to varying degrees in patients with asthma. We investigated baseline MCC and the effect of inhaled corticosteroid on MCC in chronic asthmatics while on long-term treatment with salmeterol.

Material and Methods:

Between May 2009 and July 2010, patients applied to chest disease outpatient clinic with diagnosis of asthma who were on long-term salmeterol treatment however did not receive inhaled steroid treatment and had a sputum production were recruited into the study. Pulmonary function test, ventilation test were done before commencement of inhaler steroid treatment. Eight-hundred mcg/day budesonide inhaler treatment started and measurements were repeated 4 months after beginning of inhaler steroid treatment. Mucociliary clerence was measured with gamma camera. Tc99m DTPA were used as a radioaerosol.

Results:

We recruited 25 patients with mean age 41.8 years, of these patients, 14 were female and 11 were male. Mean FEV1 was 60.40% and FEV1/FVC was 63.58% before steroid treatment. Radioaerosol retention in trachea was 52.56% at the 120 th minutes in ventilation scintigraphy. After 4 months of steroid treatment, measured radioaerosol retention in trachea was 106.92 %. There was high and significant correlation between pulmonary function test and mucociliary clearance (r=0.56 p<0.0001). and mucociliary clearance difference was statistically significant between before and after treatment (p<0.0001).

Conclusion:

To evaluate antiinflammatory treatment in asthma, clinical findings should be supported by laboratory findings. Radioaerosol measurement is non-invasive and reliable robust technique to evaluate mucociliary clearance.