According to a new research, asthmatics with mild asthma can effectively manage their ailment with a twice-daily use of inhaled steroids or switching to a daily pill.

Stephen P. Peters, M.D., Ph.D., lead author and a professor of pediatrics, internal medicine-pulmonary and associate director of the Center for Human Genomics, remarked that this is good news for asthma patients with a mild and persistent form of the disease as it offers them more choices when it comes to disease management.

The results were reported in the May 17 issue of the New England Journal of Medicine.

From News-Medical.Net:

Asthma is considered mild, but persistent, when symptoms occur more than two times a week or cause the patient to awaken during the night more than twice a month. The standard treatment for mild-persistent asthma is twice-daily use of an inhaled steroid to prevent symptoms. Patients may also take additional drugs such as the inhaler albuterol, known as “rescue” therapy, to treat symptoms. A majority of people with asthma have mild disease, according to Peters.

The study involved patients whose asthma was treated with twice-daily inhaled fluticasone propionate (Flovent Discus), a commonly prescribed synthetic steroid. This drug is designed to suppress inflammation within the airways that can cause narrowing.

Peters said that the study suggests that patients administered with twice-daily fluticasone and managing their ailment effectively may be switched to once-daily flucitasone/salmeterol without increased rates of treatment failure. He also said that montelukast, which fairs poorly when compared to inhaled medications, may still be considered as an option as a majority of patients also did well on this treatment.

Tags: albuterol, Asthma, fluticasone, Inhaled steroids, steroids

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Prazosin, which is prescribed as an antipsychotic medication, can also be used for treating prostate enlargement and high blood pressure caused by post-traumatic stress disorder, Alzheimer’s disease, depression, and schizophrenia.

The medication tends to block the increase of glucocorticoids (steroid hormones), according to researchers from the Oregon Health & Science University and Portland Veterans Affairs Medical Center.

From News-Medical.Net:

To determine the effects of prazosin, OHSU and PVAMC researchers, led by Altaf Darvesh, Ph.D., formerly of the OHSU Department of Psychiatry, administered a glucocorticoid called dexamethasone to rats, then measured the expression of a protein known as heat shock protein 70, or HSP70, that serves as a marker for neurotoxicity. Pretreatment with prazosin, an alpha-1 receptor antagonist, resulted in “significant” slowing of dexamethasone-induced expression in the cerebral cortex.

“The one thing we don’t know for sure is, would you have to get it before you’re traumatized,” Berger said. “Lots of people have high levels of corticosteroids when they’re under stress, so could we give them prazosin ahead of time to protect them from brain damage?”

Berger said future research will continue to look at where and how steroids cause brain damage, and just when prazosin would have to be administered to most effectively protect the brain against damage.

It was revealed that there is a possibility that prazosin protects the brain from getting damaged by excessive levels of corticosteroid stress hormones.

S. Paul Berger, M.D., study’s co-author and assistant professor of psychiatry and behavioral neuroscience, OHSU School of Medicine and the PVAMC, said corticosteroids may not be termed as good in cognitive terms.

Tags: corticosteroids, heat shock protein, high blood pressure, Prazosin, steroid, steroids

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Patients must make use of medicines that weaken their entire immune systems for preventing the rejection of newly transplanted organs and cells. These potentially life-saving treatments may, paradoxically, leave those administered with them susceptible to life-endangering complications.

However, researchers at the University of North Carolina at Chapel Hill School of Medicine and the UNC Lineberger Comprehensive Cancer Center have now discovered the basic behind triggering of the immune system in context to an attack transplanted cells in the very first place.

From News-Medical.Net:

The UNC study has identified a subset of cells – named TH17 cells – that can bring about the condition. Until now, without a clear understanding of the disease, clinicians have had little choice but to treat transplant patients with toxic regimens of steroids and immunosuppressive drugs.

“Our hope is that uncovering the mechanisms that cause graft-versus-host disease will allow for treatments that specifically target its causes and do not have the harmful side effects of traditional immunosuppressive therapy,” said study lead author Jonathan S. Serody, M.D., a member of the Lineberger Center and the Elizabeth Thomas Professor of Medicine, Microbiology and Immunology at UNC. The results of the study appeared in the Feb. 5, 2009, issue of Blood , the journal of the American Society of Hematology.

Graft-versus-host disease (GVHD) is a serious complication of transplants that occurs when the donor’s marrow (graft) produces immune cells that attack multiple organs of the recipient (host), typically the skin, gastrointestinal tract and liver.

Research on that TH17 branch has already sparked interest of many pharmaceutical companies. It was predicted by Serody that there would be a number of drugs coming out in the coming few years for treating immune-based skin diseases.

Tags: graft-versus-host disease, immunosuppressive therapy, steroids

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Scientists from the UT Southwestern Medical Center have found that adding corticosteroids to the traditional antimicrobial therapy may help pneumonia patients more than with antibiotics alone. Corticosteroids are generally used for treating inflammation in concern with infectious diseases while anabolic steroids are used for bulking up muscle.

Dr. Robert Hardy, associate professor of internal medicine and pediatrics and the study’s senior author, was of the view that there is no truth in the long held belief that steroids counteract the effect of the antibiotic.

From News-Medical.Net:

In the current study, mice infected with the M pneumoniae bacterium were treated daily with a placebo, an antibiotic, a steroid, or a combination of the antibiotic and steroid in order to investigate the effect on M pneumoniae-induced airway inflammation. The animals were then evaluated after one, three and six days of therapy.

“It turns out that the group that got both the antibiotic and the steroids did the best,” Dr. Hardy said. “The inflammation in their lungs got significantly better.”

Although antimicrobials remain the primary therapy for M pneumoniae infection, there have been several reports in recent years about physicians adding steroids to the treatment regimen of patients with severe cases, Dr. Hardy said. The problem, he said, is that those were individual case reports.

“They never had a control group, so it was impossible to tell what impact the addition of steroids had on recovery,” he said.

Other UT Southwestern researchers involved in the study besides Dr. Hardy were Dr. Christine Salvatore, infectious-disease fellow in pediatrics; Dr. Chonnamet Techasaensiri, postdoctoral trainee in pediatrics; Dr. Asunción Mejías, assistant professor of pediatrics; Dr. Juan Torres, visiting senior researcher in pediatrics; Kathy Katz, senior research associate in pediatrics; and Dr. Ana Maria Gomez, assistant professor of pathology, some researchers from the University of Milan also contributed to the study.

Tags: anabolic steroids, corticosteroids, pneumonia, steroids

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A high dosage of extra intramuscular corticosteroids can result in almost-complete disappearance of eosinophilic cells leading to reduced use of “rescue” medications apart from facilitating improvements in lung function tests of patients. This finding was revealed by investigators during a study of patients with severe asthma having eosinophils in their sputum despite extensive antiasthma medication.

Eosinophils are a type of white blood cell that constitute around 1-3 percent of the total white cell count in the body. When infectious cells or foreign substances enter the body, lymphocytes and neutrophils attract eosinophils that release toxic substances to destroy abnormal cells.

From News-Medical.Net:

Writing in the second issue for September 2004 of the American Thoracic Society’s peer-reviewed American Journal of Respiratory and Critical Care Medicine, Elisabeth H. Bel, M.D., Ph.D., of the Department of Pulmonary Diseases, Leiden University Medical Center, Leiden, The Netherlands, along with four associates, studied 22 non-smoking outpatients with severe asthma in order to prove that patients with extensive eosinophilia, despite significant anti-inflammatory treatment, were sensitive to high dose injected corticosteroids. Of the 22 patients in the study, 11 received the steroids and 11 were given placebo over a 3-week period. All patients had sputum eosinophilia above the upper limit of normal. However, after treatment with the injected corticosteroids, sputum eosinophils returned to normal levels (from zero to 2 percent) in the 11 treated patients.

The authors note that injected corticosteroids can reach the region of bone marrow besides minimizing eosinophils being produced by processes involving inflamed tissue.

Tags: Asthma, corticosteroids, eosinophils

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According to a small study, a potential new treatment approach for treating severe asthma has been identified. This approach is aimed at blockage of a powerful immune system chemical that is present in large quantities in patients with severe form of asthma.

It is considered that one in every ten asthmatics suffers from the severe form of the disease that occasionally requires progressively higher doses of steroids in an attempt to control symptoms.

From News-Medical.Net:

Included in the study were 26 healthy people, 67 mild asthmatics, and 51 severe asthmatics. Bronchial fluid and lung tissue samples were taken from the participants to discover their levels of TNF alpha.

Levels were significantly higher in those with severe disease and concentrated in one particular type of immune cell (mast cells) which are recognised components of the inflammatory reaction in asthma.

TNF alpha levels were low and similar in those with no asthma or who only had mild symptoms.

This suggests that the high levels of TNF alpha in severe disease are characteristic of more chronic disease that is resistant to steroid treatment, rather than a feature of the disease itself, say the authors.

The authors caution that further research is required before this approach can be recommended at any stage but that does not mean, in any way, that this approach is not a potentially new avenue of treatment for severe asthma.

Tags: Asthma, severe asthma, steroids

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Telithromycin, an antibiotic, has been found to be an effective option for treating acute asthma attacks. This finding was highlighted in a research published in the New England Journal of Medicine that demonstrated that the antibiotic can be used to provide relief to patients suffering from asthma.

The team of involved researchers was from Imperial College London, the University of Milan, the University of Auckland, the National Jewish Medical Centre, USA, G.R. Micro Ltd, London, and sanofi-aventis, USA.

From News-Medical.Net:

Professor Sebastian Johnston from Imperial College London, who led the research, said: “Traditionally antibiotics have not proven effective in treating asthma attacks, but this development could open up a whole new area of research in the treatment of asthma. Although we’re not sure about the exact mechanism which caused this antibiotic to be effective, this study indicates it does clearly have a beneficial effect. We still need further trials to confirm these results, to investigate the mechanisms of action of this treatment, to see if the same benefits are seen with other related antibiotics and to see which patients are most likely to benefit.”

It is worth noting here that treatment for some serious asthma attacks may involve the use of steroids to control lung inflammation and bronchodilators to open airways.

Tags: acute asthma, Asthma, steroids, Telithromycin

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As per a research by scientists at the University of Bristol and the National Cancer Institute (NCI), USA, gene activity can be affected via intermittent signaling by steroid hormones.

These findings were published online and appeared in the September 2009 issue of Nature Cell Biology.

It is believed that this finding would have major implications to ascertain how steroids work besides opening novel avenues to new therapies.

From News-Medical.Net:

In this new study, the researchers demonstrate that ultradian hormone stimulation induces the pulsed expression of genes (known as gene pulsing) over the same period, both in cultured cells and in animal models. Initially, the researchers administered corticosterone, a naturally occurring glucocorticoid hormone in rodents, in a pulsed manner to cultured mouse cells and then observed that the levels of newly synthesized RNA from glucocorticoid receptor-regulated genes tracked precisely with the hormone pulses.

The reported research results argue that gene pulsing regulated by glucocorticoid receptors is directly linked to varying levels of gene activity. Professor Stafford Lightman, head of the Henry Wellcome Laboratories for Integrative Neuroscience and Endocrinology, at the University of Bristol, said: “We have previously shown that the hormone cortisol is released in pulses in man as well as rodents. The present results now show that this pattern of hormone release is critical for good health and provides a novel concept for new drug design.”

It is considered by members of the medical fraternity that such studies would help in defining the potential role of ultradian application of glucocorticoid receptor therapy to a significant extent.

Tags: glucocorticoid, steroid, steroid hormones, steroids

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According to a new University of Florida study, the simple acts of exercise and not fitness itself can convince you about your “smart” appearance.

It was remarked by Heather Hausenblas, a UF exercise psychologist, that individuals who do not attain workout milestones like gaining strength, boosting cardiovascular fitness, and losing fat feel as good as their more athletic peers.

This study was published in the September issue of the Journal of Health Psychology.

From News-Medical.Net:

“Body dissatisfaction is a huge problem in our society and is related to all sorts of negative behavior including yo-yo dieting, smoking, taking steroids and undergoing cosmetic surgery,” she said. “It affects men and women and all ages, starting with kids who are as young as five years old saying they don’t like how their bodies look.”

The psychological advantages of exercise have been less explored, including the reduction of depression or confidence in body image, compared with the well-researched and understood physical benefits, she said.

The study found no difference in body image improvement between people who met the American College of Sports Medicine guidelines by exercising at least 30 minutes a day five days a week and those who did not, Hausenblas said. The guidelines are considered the minimum amount of exercise needed to receive the health related benefits of physical activity, she said.

Kathleen Martin Ginis, a kinesiology professor at McMaster University in Ontario, Canada, and exercise expert remarked while praising this research by saying that this study shows that any exercise on a regular basis can help individuals feel better about their bodies and frequent bouts of lower intensity exercise can easily enhance body image.

Tags: body image improvement, cosmetic surgery, dieting, steroids

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Dermatologist Michael David, MD, Dermatology Department at Rabin Medical Center, Tel Aviv, Israel, and his colleagues, have found an increased occurrence of diabetes and atherosclerosis in psoriasis patients compared to patients without psoriasis. This finding was published in an issue of Journal of the American Academy of Dermatology.

Psoriasis is a chronic skin condition that is characterized by thick, red, scaly plaques that itch and featured by bleeding at times to result in discomfort and emotional stress for patients.

This finding is believed to give relief to 2-4 percent of the worldwide population affected by psoriasis, including approximately 5.8 to 7.5 million Americans affected by the condition.

From News-Medical.Net:

“When we compared the age-adjusted proportion of diabetes and atherosclerosis between patients with psoriasis and those patients in the control group, we found that the proportion of both medical conditions was significantly higher in psoriasis patients vs. the control group,” said Dr. David. “Examining the data among the psoriasis patients by age and gender, we also found several interesting associations.”

Specifically, the researchers noted that the association between diabetes and psoriasis was more prominent in women compared to men and in patients between the ages of 35 and 55. Similarly, the association between atherosclerosis and psoriasis was highest among women as compared with men and in patients between the ages of 35 and 55, and 65 and 75.

In addition, in patients with psoriasis, data analysis showed an association between diabetes and the overuse of extremely potent topical steroids or certain systemic medications for psoriasis. The researchers suggested that these observations could indicate that the prevalence of diabetes among psoriasis patients increases with the severity of psoriasis.

Dr. David remarked that though the study suggested an association between psoriasis, diabetes and atherosclerosis, the cause of this association is not known by now besides why there is an increased risk of both conditions in women and certain age groups.

Tags: atherosclerosis, diabetes, psoriasis, steroids, topical steroids

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