Topical tacrolimus in atopic dermatitis: Effects of ... - Helda - Helsinki.fi

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Respiratory symptoms and findings To exclude seasonal variation in respiratory symptoms, patients were enrolled from late October to early January after the pollen season and before the typical respiratory infection epidemics. Measurements were done once for the study groups in Study III, and at baseline and after 12 months of treatment in Study V. Lung function tests The forced expiratory volume in one second (FEV1) (Quanjer et al. 1993) was recorded with a flow-volume spirometer (Medikro 905, Medikro Oy, Kuopio, Finland), with results expressed as percentages of the national predicted values (Viljanen et al. 1982). Bronchial hyper-responsiveness was evaluated with a dosimetric histamine challenge test employing increasing inhaled doses of 0.025, 0.1, 0.4, and 1.6 mg buffered histamine diphosphate (Sovijärvi et al. 1993). Based on the dose-response curve, the provocative dose of inhaled histamine producing a decrease of 15% in FEV1 (PD15FEV1) was determined. According to PD15FEV1, bronchial hyperreactivity was graded as mild (0.41-1.60 mg), moderate (0.11-0.40 mg) or severe (1.6 mg were considered to have normal bronchial responsiveness. Additionally, the result was expressed in terms of the slope of the dose response curve, as a continuous and log-normally distributed index (O’Connor et al. 1987). At the time of lung function testing, all patients were free from respiratory tract infections for at least the preceding 2 weeks, and short-acting beta-2-agonists were withheld for at least the previous 12 hours. Questionnaire A previously validated questionnaire was chosen for estimating the prevalence of physician-diagnosed asthma and allergic rhinitis (Haahtela et al. 1980). The degree of asthma symptoms (cough, wheezing, dyspnoea) and of nasal symptoms experienced by the AD patients during the preceding year were estimated on a visual analogue scale (VAS) from 0 to 10 cm. AD patients with symptoms of at least 1 cm in VAS in Study III and of at least 2 cm in VAS in Study V were considered to have current asthma or nasal symptoms. The patients in Study V answered the questionnaire also at 48 months of treatment. The control subjects in Study III gave qualitative answers as to any possible asthmatic or nasal symptoms. Induced sputum Sputum was induced by inhalation of 5 ml of 3% NaCl solution, with an ultrasonic nebulizer (Omron U1, Omron, Germany) for 15 minutes (Djukanovic et al. 2002, Metso et al. 2001). Subjects were pre-treated with 200 �g salbutamol (Buventol Easyhaler 100 microg/dose��Orion Pharma), by inhalation. PEF values were measured before and 44
after induction, to ensure safety of the procedure. If PEF fell by more than 15%, or troublesome symptoms appeared, patients were treated with 200 �g of inhaled salbutamol. Subjects were asked to cough during and after inhalation, and sputum samples were collected in empty containers. The more viscous parts of the samples were collected and mixed for air-dried smears which were stained with eosin and methylene blue. Eosinophilia was graded semi-quantitatively, on a scale from 0 to 4 (Rytilä et al. 2002), as relative proportions of eosinophils of all non-squamous cells: less than 1%, 1 to 5%, 6 to 10%, 11 to 50%, and >50%, respectively. In Study V, the cell proportion of grade 0 was determined as 60 cells per slide). The result was expressed as the mean count of both eyes. 45
Page 1 and 2: Topical tacrolimus in atopic dermat
Page 3: To Juha and Veera
Page 6 and 7: Effects of treatment on skin barrie
Page 8 and 9: ABBREVIATIONS AD Atopic dermatitis
Page 10 and 11: and bronchial hyper-responsiveness
Page 12 and 13: REVIEW OF THE LITERATURE Atopic der
Page 14 and 15: probably plays a protective role ag
Page 16 and 17: e induced by IL-2 and bacterial sup
Page 18 and 19: and has a lower risk for asthma and
Page 20 and 21: Both asthma and allergic rhinitis i
Page 22 and 23: early childhood, and is accompanied
Page 24 and 25: naturally occurring glucocorticoste
Page 26 and 27: severe atopic dermatitis, hand ecze
Page 28 and 29: and their complex inhibits activati
Page 30 and 31: extent of topical absorption decrea
Page 32 and 33: of one type of treatment can be bet
Page 34 and 35: liver (Burgeson & Nimni 1992). At l
Page 36 and 37: UVA therapy suppresses collagen syn
Page 38 and 39: AIMS OF THE STUDY Atopic dermatitis
Page 40 and 41: Inclusion criteria Patients with mo
Page 42 and 43: Methods Treatment with tacrolimus o
Page 46 and 47: Statistical methods In Studies I, I
Page 48 and 49: Staphylococcus aureus colonization
Page 50 and 51: Table 7. Subject characteristics; o
Page 52 and 53: physician-diagnosed asthma (2.09 vs
Page 54 and 55: In Study V, eight (12%) patients us
Page 56 and 57: Skin collagen synthesis The results
Page 58 and 59: Results of the present uncontrolled
Page 60 and 61: al. 1986, Burrows et al. 1989, Kono
Page 62 and 63: ACKNOWLEDGEMENTS This study was car
Page 64 and 65: REFERENCES Aberer W, Wolff K. Syste
Page 66 and 67: Bousquet J; Jeffery PK, Busse WW, J
Page 68 and 69: Dold S, Wjst M, von Mutius E, Reitm
Page 70 and 71: Haapasaari K. Rossi O. Risteli J. O
Page 72 and 73: Krutmann JT, Morita A. Phototherapy
Page 74 and 75: Nishino K, Fukushima A, Okamoto S,
Page 76 and 77: Quanjer PH, Tammeling GJ, Cotes JE,
Page 78 and 79: Schultz-Larsen F, Diepgen T, Svenso
Page 80 and 81: Tsai WC, Pang JH, Hsu CC, Chu NK, L
Page 82: ERRATA Page 36: In Table 2 in the c

Topical tacrolimus in atopic dermatitis: Effects of ... - Helda - Helsinki.fi

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