Inhaled Corticosteroids and Their Affect on Reticular Basement Membrane Thickening in Patients with Asthma

INTRODUCTION: Asthma has been recognized as a disease with two main components: airway inflammation and airway remodeling. One particular aspect of airway remodeling, reticular basement membrane (RBM) thickening has been noted as a feature of asthmatic airways that could contribute to disease severity. The use of inhaled corticosteroids (ICS) has been observed to reduce inflammation in the airways of asthmatics, but its affects on specific components of airway remodeling are still in question. METHODS: The focus of this study was to review the current literature for the last 10 years on all studies pertaining to RBM thickening in asthmatics and whether the use of ICS can reduce the RBM as determined by bronchial biopsy. RESULTS: In the four studies reviewed, RBM thickening was noted in mild, moderate, or severe asthmatics as a group when compared to healthy controls. ICS use demonstrated a significant reduction in RBM thickness, when compared to asthmatic subjects who only used bronchodilators for symptom control. The greatest benefit to ICS use was noted when used at moderate to high dosages for periods longer than three months. CONCLUSION: Long term, high dose ICS are effective at reducing RBM thickness in asthmatics. Although RBM thickening has been correlated with other signs of asthma severity such as airway hyperresponsiveness (AHR), further studies are needed to relate pathological changes to physiological measurements in asthma patients. Degree Type Capstone Project Rights Terms of use for work posted in CommonKnowledge. This capstone project is available at CommonKnowledge: http://commons.pacificu.edu/pa/146 Copyright and terms of use If you have downloaded this document directly from the web or from CommonKnowledge, see the “Rights” section on the previous page for the terms of use. If you have received this document through an interlibrary loan/document delivery service, the following terms of use apply: Copyright in this work is held by the author(s). You may download or print any portion of this document for personal use only, or for any use that is allowed by fair use (Title 17, §107 U.S.C.). Except for personal or fair use, you or your borrowing library may not reproduce, remix, republish, post, transmit, or distribute this document, or any portion thereof, without the permission of the copyright owner. [Note: If this document is licensed under a Creative Commons license (see “Rights” on the previous page) which allows broader usage rights, your use is governed by the terms of that license. ] Inquiries regarding further use of these materials should be addressed to: CommonKnowledge Rights, Pacific University Library, 2043 College Way, Forest Grove, OR 97116, (503) 352-7209. Email inquiries may be directed to:. copyright@pacificu.edu This capstone project is available at CommonKnowledge: http://commons.pacificu.edu/pa/146 NOTICE TO READERS This work is not a peer-reviewed publication. The Master’s Candidate author(s) of this work have made every effort to provide accurate information and to rely on authoritative sources in the completion of this work. However, neither the author(s) nor the faculty advisor(s) warrants the completeness, accuracy or usefulness of the information provided in this work. This work should not be considered authoritative or comprehensive in and of itself and the author(s) and advisor(s) disclaim all responsibility for the results obtained from use of the information contained in this work. Knowledge and practice change constantly, and readers are advised to confirm the information found in this work with other more current and/or comprehensive sources. The student authors attest that this work is completely their original authorship and that no material in this work has been plagiarized, fabricated or incorrectly attributed. INHALED CORTICOSTEROIDS AND THEIR AFFECT ON RETICULAR BASEMENT MEMBRANE THICKENING IN PATIENTS WITH ASTHMA