Effects of TMK-688 a potent 5-lipoxygenase inhibitor, on dual-phase asthmatic response in conscious guinea pigs sensitized with ovalbumin

We evaluated the anti-asthmatic effects and mechanism of action of TMK-688, a potent 5-lipoxygenase inhibitor, on the dual-phase asthmatic response and on airway inflammation in conscious guinea pigs sensitized with ovalbumin (OA). TMK-688 inhibited both the immediate and the late asthmatic response (LAR) after administration of a single oral dose of 3.2 or 10 mg/kg 2 h before OA challenge. Pretreatment with TMK-688 also inhibited airway hyperresponsiveness to acetylcholine. The increase in eosinophils in bronchoalveolar lavage fluid and the production of reactive oxygen, an index of cell activation during LAR, was also suppressed by TMK-688. These findings suggest the following inhibitory mechanism of LAR by TMK-688: (i) a reduction of eosinophil accumulation in airways; (ii) the inhibition of the immediate asthmatic response; (iii) the inhibition of airway hyperresponsiveness; and (iv) the suppression of the generation of reactive oxygen from bronchoalveolar lavage cells

Comparison of the Asthma Health Questionnaire-33-Japan and the Short-Form 36-Item Health Survey for Measuring Quality of Life in Japanese Patients with Asthma

Background: The Asthma Health Questionnaire (AHQ)-Japan is useful for assessing quality of life (QOL) in Japanese patients with asthma. However, no studies have compared the AHQ-Japan to other QOL instruments. Methods: The AHQ-33-Japan and the Medical Outcomes Study Short-Form 36-Item Health Survey (SF-36) were completed simultaneously by 126 Japanese patients with asthma (48 men, 78 women; 58.1 ± 17.3 years of age), and the data were compared. Results: Poor negative correlations (correlation coefficient (r) = -0.20 to -0.44, P < 0.05) were observed for 38 combinations of the subscales of these QOL instruments. As the severity of the patients' asthma increased, the scores of most subscales of both QOL instruments became worse. However, the AHQ-33 was more sensitive for severity than the SF-36. On logistic regression analysis, high Asthmatic Symptoms, Factors which Worsened Symptoms, Emotion, Daily Activity, and Social Activity subscale scores, as well as a high total 32- item score, of the AHQ-33 were associated with an increased risk of moderate to severe asthma. On the other hand, only the Physical functioning subscale score of the SF-36 was associated with an increased risk of moderate to severe asthma. Conclusions: Our results show that the AHQ-33 is useful as a disease-specific QOL instrument in Japanese patients with asthma and that it is better than the SF-36, which is a generic QOL instrument. In the future, the AHQ-33 should be compared to other asthma-specific questionnaires

Which inhaled corticosteroid and long-acting β-agonist combination is better in patients with moderate-to-severe asthma, a dry powder inhaler or a pressurized metered-dose inhaler?

<p>Two main types of devices are used to facilitate the administration of inhaled corticosteroid (ICS) and long-acting β-agonist (LABA) in combination, dry powder inhalers (DPIs) and pressurized metered-dose inhalers (pMDIs). There are few reports comparing the effects of the two devices, and it is unknown which should be recommended for asthma patients with given sets of characteristics. In the current study, the beneficial effects and side effects associated with DPIs and pMDIs were compared, and the question of which device should be recommended for asthma patients was investigated. A prospective, randomized, crossover, comparative study in adult outpatients with asthma was conducted using salmeterol/fluticasone propionate combination (SFC) 50 μg/250 μg, one inhalation of Adoair^® 250 Diskus^® twice daily or two inhalations of Adoair^® 125 Aerosol twice daily, for 8 weeks. Questionnaires, exhaled nitric oxide (FeNO) tests and pulmonary function tests were administered after the use of each device for 8 weeks, and the results derived from each device were compared. Sixty-eight subjects were included in the final analysis. There were no significant differences between quality-of-life scores, FeNO, spirometry test results and forced oscillation results. With regard to patient preferences, 57.4% preferred the Adoair^® Aerosol and 35.3% preferred the Adoair^® Diskus^®, as determined via the comparative evaluation questionnaire. Although DPI prescription accounts for the predominant market share of combined ICS/LABA in Japan, patients preferred a pMDI device to a DPI device. Compared to DPIs, pMDIs may be the preferential choice for patients with asthma.</p