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Efficacy of dexamethasone, salbutamol, and reduced respirable particulate concentration on aerobic capacity in horses with smoke-induced mild asthma.

ABSTRACT: BACKGROUND:Mild asthma in horses decreases racing performance and impairs gas exchange. The efficacy of treatment on performance is unknown. HYPOTHESIS:Treatment targeting lung inflammation improves V? O2 peak in horses with mild asthma. ANIMALS:Thoroughbred polo horses (n = 12) with smoke-induced mild asthma. Horses were exposed to increased ambient particulate matter (35.51??g/m3 [PM2.5 ]; day mean, centrally measured) from day -33 to 0, from bushfire smoke (natural model). METHODS:Prospective, randomized, placebo-controlled, double-blinded clinical trial. All horses completed 3 V? O2 peak tests, measuring aerobic and anaerobic variables: day 0 -baseline; day 16 -after dexamethasone (20?mg IM q24h; DEX, n = 6) or saline treatment (SALINE, n = 6), under improved ambient PM2.5 concentrations (7.04??g/m3 ); day 17-15-30mins after inhaled salbutamol (1500??g). Bronchoalveolar lavage and mucus scoring were performed on day -8 and day 20. Linear mixed effects models were used to examine the effects of timepoint and treatment group on BAL differential cell counts, mucus scores, aerobic and anaerobic variables. RESULTS:Horses' mucus scores improved significantly from day -8 to 20 by 1.27?±?.38 (P = .01). There was a significant increase in V? O2 peak of 15.5?±?4.0 mL(min.kg)-1 from day 0 to 17 (P = .002), representing an average (mean) increase in V? O2 peak of 13.2%. There was no difference in V?O2 peak between treatment groups (SALINE versus DEX) at any timepoint. CONCLUSIONS AND CLINICAL IMPORTANCE:This study highlighted the key role of improved air quality on functionally important airway inflammation. Evidence provided is central to increasing owner compliance regarding improved air quality for the treatment and prevention of mild asthma.

SUBMITTER: Bond SL

PROVIDER: S-EPMC7096652 | biostudies-literature | 2020 Mar

REPOSITORIES: biostudies-literature

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Efficacy of dexamethasone, salbutamol, and reduced respirable particulate concentration on aerobic capacity in horses with smoke-induced mild asthma.

Bond Stephanie L SL Greco-Otto Persephone P MacLeod Jacqueline J Galezowski Angelica A Bayly Warwick W Léguillette Renaud R

Journal of veterinary internal medicine 20200118 2

<h4>Background</h4>Mild asthma in horses decreases racing performance and impairs gas exchange. The efficacy of treatment on performance is unknown.<h4>Hypothesis</h4>Treatment targeting lung inflammation improves V ˙ O<sub>2</sub> peak in horses with mild asthma.<h4>Animals</h4>Thoroughbred polo horses (n = 12) with smoke-induced mild asthma. Horses were exposed to increased ambient particulate matter (35.51 μg/m<sup>3</sup> [PM<sub>2.5</sub> ]; day mean, centrally measured) from day -33 to 0, ...[more]

PMID: 31953974

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Project description:ObjectiveInhalation of ozone activates central sympathetic-adrenal-medullary and hypothalamic-pituitary-adrenal stress axes. While airway neural networks are known to communicate noxious stimuli to higher brain centers, it is not known to what extent responses generated from pulmonary airways contribute to neuroendocrine activation.Materials and methodsUnlike inhalational exposures that involve the entire respiratory tract, we employed intratracheal (IT) instillations to expose only pulmonary airways to either soluble metal-rich residual oil fly ash (ROFA) or compressor-generated diesel exhaust particles (C-DEP). Male Wistar-Kyoto rats (12-13 weeks) were IT instilled with either saline, C-DEP or ROFA (5 mg/kg) and necropsied at 4 or 24 hr to assess temporal effects.ResultsIT-instillation of particulate matter (PM) induced hyperglycemia as early as 30-min and glucose intolerance when measured at 2 hr post-exposure. We observed PM- and time-specific effects on markers of pulmonary injury/inflammation (ROFA>C-DEP; 24 hr>4hr) as corroborated by increases in lavage fluid injury markers, neutrophils (ROFA>C-DEP), and lymphocytes (ROFA). Increases in lavage fluid pro-inflammatory cytokines differed between C-DEP and ROFA in that C-DEP caused larger increases in TNF-α whereas ROFA caused larger increases in IL-6. No increases in circulating cytokines occurred. At 4 hr, PM impacts on neuroendocrine activation were observed through depletion of circulating leukocytes, increases in adrenaline (ROFA), and decreases in thyroid-stimulating-hormone, T3, prolactin, luteinizing-hormone, and testosterone. C-DEP and ROFA both increased lung expression of genes involved in acute stress and inflammatory processes. Moreover, small increases occurred in hypothalamic Fkbp5, a glucocorticoid-sensitive gene.ConclusionRespiratory alterations differed between C-DEP and ROFA, with ROFA inducing greater overall lung injury/inflammation; however, both PM induced a similar degree of neuroendocrine activation. These findings demonstrate neuroendocrine activation after pulmonary-only PM exposure, and suggest the involvement of pituitary- and adrenal-derived hormones.

Project description:BackgroundA combination of ipratropium bromide (IB) and salbutamol is commonly used to treat asthma in children and adolescents; however, there has been a lack of consistency in its usage in clinical practice.ObjectiveTo evaluate the efficacy and safety of IB + salbutamol in the treatment of asthma in children and adolescents.MethodsThe MEDLINE, Embase, and Cochrane Library as well as other Chinese biomedical databases (including China Biological Medicine Database, Chinese National Knowledge Infrastructure, Chongqing VIP, and Wanfang Chinese language bibliographic database) were systematically searched from the earliest record date to September 2020 for randomized controlled trials in children and adolescents (≤18 years) with asthma who received IB + salbutamol or salbutamol alone. The primary outcomes included hospital admission and adverse events. A random effects model with a 95% confidence interval (CI) was used. Subgroup analysis was performed according to age, severity of asthma, and co-interventions with other asthma controllers. This study was registered with PROSPERO.ResultsOf the 1061 studies that were identified, 55 met the inclusion criteria and involved 6396 participants. IB + salbutamol significantly reduced the risk of hospital admission compared with salbutamol alone (risk ratio [RR] 0.79; 95% CI 0.66-0.95; p = 0.01; I2 = 40%). Subgroup analysis only showed significant difference in the risk of hospital admission in participants with severe asthma exacerbation (RR 0.73; 95% CI 0.60-0.88; p = 0.0009; I2 = 4%) and moderate-to-severe exacerbation (RR 0.69; 95% CI 0.50-0.96; p = 0.03; I2 = 3%). There were no significant differences in the risk of adverse events between IB + salbutamol group and salbutamol alone group (RR 1.77; 95% CI 0.63-4.98).ConclusionIB + salbutamol may be more effective than salbutamol alone for the treatment of asthma in children and adolescents, especially in those with severe and moderate to severe asthma exacerbation. The very low to high quality of evidence indicated that future well-designed double-blind RCTs with large sample are needed for research on evaluating the effectiveness of IB + salbutamol treatment for asthma in children and adolescents.

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Dataset Information

Efficacy of dexamethasone, salbutamol, and reduced respirable particulate concentration on aerobic capacity in horses with smoke-induced mild asthma.

Publications

Efficacy of dexamethasone, salbutamol, and reduced respirable particulate concentration on aerobic capacity in horses with smoke-induced mild asthma.

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