Clinical Efficacy and Influencing Factors of Budesonide Inhalation in the Treatment of Cough Variant Asthma in Adults
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Abstract
Objective: To analyze the clinical efficacy and influencing factors of budesonide inhalation therapy in adult Cough variant asthma (CVA).
Methods: This retrospective study involved 223 CVA patients who were treated in the hospital from January 2022 to February 2024. These patients received standard symptomatic treatment (such as cough suppression, expectoration, and anti-infection therapies), along with budesonide inhalation therapy. The main objective of the study was to evaluate the clinical effects before and after treatment, including lung function, serum inflammatory factor levels, and immune function, while also recording any adverse reactions that occurred during treatment. We classified the patients into effective and ineffective groups based on treatment outcomes, collected clinical factors related to efficacy, and used logistic regression analysis to investigate the factors affecting treatment effectiveness.
Results: After treatment, the lung function indicators of patients showed significant improvement, with the forced expiratory volume in one second (FEV1), forced vital capacity (FVC), and peak expiratory flow (PEF) all increasing compared to before treatment. At the same time, the levels of tumor necrosis factor-alpha (TNF-α), interleukin-4 (IL-4), and immunoglobulin E (IgE) in the serum decreased. In terms of immune function, the levels of CD3+ and CD4+ cells were increased, while the level of CD8+ cells decreased. Thirteen patients (5.83%) experienced nausea and indigestion during the treatment process, nine patients (4.04%) had drowsiness and fatigue, and seven patients (3.14%) had discomfort in the throat. Based on the therapeutic efficacy evaluation after treatment, patients were divided into an effective group (n=188) and an ineffective group (n=35). Further multivariate logistic regression analysis revealed that older age (OR=1.570), lower levels of 25-hydroxyvitamin D3 [25(OH)D3] (OR=0.798), and high levels of tumor necrosis factor-alpha (TNF-α) (OR=1.850) increased the risk of reduced therapeutic efficacy.
Conclusion: Budenoside inhalation therapy is effective for CVA patients, as it can improve lung function, reduce inflammation, and enhance immune function. However, factors such as age, 25(OH)D3, and TNF-α may influence the treatment outcomes.
2.Morice AH, Millqvist E, Bieksiene K, Birring SS, Dicpinigaitis P, Domingo Ribas C, et al. ERS guidelines on the diagnosis and treatment of chronic cough in adults and children. Eur Respir J. 2020;55(1):1901136.
3.Côté A, Russell RJ, Boulet LP, Gibson PG, Lai K, Irwin RS, et al. Managing Chronic Cough Due to Asthma and NAEB in Adults and Adolescents: CHEST Guideline and Expert Panel Report. Chest. 2020;158(1):68-96.
4.Ibrahim Arif S, Amer YS, Adnan Alkamal T, Abdulrahman Binsaeed M, Ibrahim Arif B, Dhaifallah Albaqami M, et al. Patient response to the management during the acute presentation of cough variant Asthma: Retrospective cohort study. Saudi J Biol Sci. 2023;30(12):103875.
5.Yi F, Zhan C, Liu B, Li H, Zhou J, Tang J, et al. Effects of treatment with montelukast alone, budesonide/formoterol alone and a combination of both in cough variant asthma. Respir Res. 2022;23(1):279.
6.Zhou J, Yi F, Wu F, Xu P, Chen M, Shen H, et al. Characteristics of different asthma phenotypes associated with cough: a prospective, multicenter survey in China. Respir Res. 2022;23(1):243.
7.Ramos-Ramírez P, Tliba O. Glucocorticoid Insensitivity in Asthma: The Unique Role for Airway Smooth Muscle Cells. Int J Mol Sci. 2022;23(16):8966.
8.Matsumura Y. Inadequate therapeutic responses to glucocorticoid treatment in bronchial asthma. J Int Med Res. 2023;51(6):3000605231175746.
9.Asthma Workgroup, Chinese Society, Respiratory, Diseases (CSRD), Chinese Medical, Association. The Chinese national guidelines on diagnosis and management of cough (December 2010). Chin Med J (Engl). 2011;124(20):3207-19.
10.Lai K, Zhan W, Wu F, Zhang Y, Lin L, Li W, et al. Clinical and Inflammatory Characteristics of the Chinese APAC Cough Variant Asthma Cohort. Front Med (Lausanne). 2022;8(14):807385.
11.Niu Y, Cao M, Li S, Mo J, Zhu Z, Wang H. The Effects of Budesonide Inhalation Treatment on the Expression Levels of Serum IL-6, TGF- β1, and IgE and Pulmonary Function in Patients with Cough Variant Asthma and an Evaluation of Treatment Efficacy. Int J Gen Med. 2024; 29(17):1253-61.
12.Wang XP, Yang LD, Zhou JF. Montelukast and budesonide combination for children with chronic cough-variant asthma. Medicine (Baltimore). 2018;97(30):e11557.
13.Guo S, Cao C. Effects of montelukast sodium combined with budesonide on pulmonary function, serum IgE levels, and EOS percentage in children with comorbid allergic rhinitis and asthma. Am J Transl Res. 2023;15(12):6823-31.
14.Song Y, Li R. Effect of budesonide combined with salbutamol nebulization on pulmonary function and serum immune factors in children with bronchiolitis. Am J Transl Res. 2021;15;13(7):8158 -64.
15.Pace E, Di Sano C, Ferraro M, Bruno A, Caputo V, Gallina S, et al. Budesonide increases TLR4 and TLR2 expression in Treg lymphocytes of allergic asthmatics.Pulm Pharmacol Ther. 2015;32(8):93-100.
16.Dai L, Liu B, Lin J, Jiang Y, Li Y, Yao Z, et al. Long-acting anti-inflammatory injectable DEX-Gel with sustained release and self-healing properties regulates TH1/TH2 immune balance for minimally invasive treatment of allergic rhinitis. J Nanobiotechnolog y. 2024;22(1):51.
17.Pace E, Di Sano C, La Grutta S, Ferraro M, Albeggiani G, Liotta G, et al. Multiple in vitro and in vivo regulatory effects of budesonide in CD4+ T lymphocyte subpopulations of allergic asthmatics. PLoS One. 2012;7(12):e48816.
18.Tang Q, Lei H, You J, Wang J, Cao J. Evaluation of efficiency and safety of combined montelukast sodium and budesonide in children with cough variant asthma: A protocol for systematic review and meta-analysis. Medicine (Baltimore). 2021;100(25):e26416.
19.Jin FD, Wang J, Deng SJ, Song WJ, Zhang X, Wang CY, et al. Interaction effect of chronic cough and ageing on increased risk of exacerbation in patients with asthma: a prospective cohort study in a real-world setting. ERJ Open Res. 2023 Dec 27;9(6):00461-2023.
20.McGeachie MJ, Sordillo JE, Dahlin A, Wang AL, Lutz SM, Tantisira KG, et al. Expression of SMARCD1 interacts with age in association with asthma control on inhaled corticosteroid therapy.Respir Res. 2020;21(1):31.
21.Ganji V, Al-Obahi A, Yusuf S, Dookhy Z, Shi Z. Serum vitamin D is associated with improved lung function markers but not with prevalence of asthma, emphysema, and chronic bronchitis. Sci Rep. 2020;10(1):11542
22.Uzer F, Ozbudak O. Are 25(OH) D concentrations associated with asthma control and pulmonary function test? Caspian J Intern Med. 2019;10(4):377-382.
23.Jaura J, Kelsberg G, Safranek S. Does vitamin D supplementation reduce asthma exacerbations? J Fam Pract. 2020;69(4):E4-E6.
24.Jolliffe DA, Stefanidis C, Wang Z, Kermani NZ, Dimitrov V, White JH, et al. Vitamin D Metabolism Is Dysregulated in Asthma and Chronic Obstructive Pulmonary Disease. Am J Respir Crit Care Med. 2020;202(3):371 -82.
25.Chen L, Huang M, Xie N. The effect of montelukast sodium plus budesonide on the clinical efficacy, inflammation, and pulmonary function in children with cough variant asthma. Am J Transl Res. 2021;13(6):6807-16.
26.Ricciardolo FLM, Folkerts G, Folino A, Mognetti B.Bradykinin in asthma: Modulation of airway inflammation and remodelling. Eur J Pharmacol. 2018;827(16):181-8.
| Files | ||
| Issue | Vol 24 No 2 (2025) | |
| Section | Original Article(s) | |
| DOI | https://doi.org/10.18502/ijaai.v24i2.18142 | |
| Keywords | ||
| Budesonide Treatment outcome Cough variant asthma Immune system phenomena Risk factor | ||
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