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Steroid Resistance in Bronchial Asthma
- HOWARD J. SCHWARTZ, M.D.;
- FRANCIS C. LOWELL, M.D., F.A.C.P.; and
- JAMES C. MELBY, M.D.
- Requests for reprints should be addressed to Francis C. Lowell, M.D., Allergy Unit, Massachusetts General Hospital, Boston, Mass. 02114.
SUMMARY
The eosinopenic response to 40 mg of cortisol given intravenously was studied in 19 unselected asthmatics (group A) and in 6 asthmatics who exhibit clinical resistance to cortisol's antiasthma effect (group B). The changes in total eosinophil counts were -35%, -77%, and -73% in group A; and -10%, -36%, and 3.6% in group B at 2, 4, and 6 hr after administration.
Cortisol turnover studies in four subjects from each group were done using a tracer dose of tritium-labeled cortisol immediately followed by 40 mg of unlabeled cortisol intravenously. Plasma levels were measured at 30, 60, 90, and 120 min; 6-hr urine collections were made. Cortisol half-life values in group A were 123, 133, 120, and 132 min; in group B they were 81, 96, 75, and 90 min.
Thus, asthma requiring unusually large doses of steroid for control may be associated with a decreased eosinopenic response to cortisol and an accelerated plasma cortisol clearance.
Article and Author Information
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From the Department of Medicine, Harvard Medical School; the Allergy Unit, Massachusetts General Hospital; the Department of Medicine, Boston University School of Medicine; and the Endocrine Unit, University Hospitals; Boston, Mass.
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This study was supported by grants 2T1 22-09, AI 02638-09, AM 08657-03, and AM 06608-05, U. S. Public Health Service, Washington, D. C.
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- Received March 20, 1968.
- Accepted May 24, 1968.
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