According to a study, some children suffering from asthma are genetically less responsive to inhaled corticosteroids.

It was remarked by researcher Gregory Sawicki, M.D. of Children’s Hospital in Boston, that there can be many reasons for this finding.

Dr. Sawicki noted that many studies of asthmatic adults have already suggested that even rigorous use of inhaled steroids does not lead to well controlled asthma in all adults.

From News-Medical.Net:

Of the 914 children in the study, inhaled steroids were recommended for 435 who had persistent asthma, meaning they had symptoms on a regular basis. Among children who weren’t recommended for inhaled steroid treatment, most reported well-controlled asthma. Among those recommended for inhaled steroid treatment, 44% reported consistently using the medicine; 35% said they intermittently used the medicine and 21% said they didn’t use it at all.

“The majority of children with mild asthma are less likely to have symptoms as they get older and may not need to be on daily steroids,” Dr. Sawicki said. “The flip side is that if a child has poor asthma control, the parents and doctor need to make sure the child is adhering to their inhaled steroid treatment. But variation in response to inhaled steroids, as other medications, is well described.”

This data came from the Child Asthma Management Program Continuation Study (CAMPCS), one of the largest groups of children with mild to moderate asthma in the nation who have been followed over 10 years.

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According to a new review of studies about the use of anti-inflammatory steroids for traumatic head injuries such as car crashes, the risk of death is increased due to such usage.

This analysis that was published by the British-based Cochrane Library draws heavily from a study of corticosteroid treatment for brain injury involving more than 10,000 patients.

Dr. Phil Alderson, lead author of the Cochrane study, said that the considerable increase in death with steroids found participating in the trial suggests that steroids are no longer to be routinely used in patients with traumatic head injury.

From News-Medical.Net:

Corticosteroids are “widely used in medicine to treat inflammation,” Alderson explains. “It is thought that some of the damage after a brain injury results from inflammation following the initial injury and that reducing inflammation might reduce this secondary injury.”

In the case of severe head injuries, the inflammation leads to swelling of the brain and its surrounding tissues, which in turns creates pressure in the skull that may lead to complications or death.

The 17 studies on steroid use and the risk of death examined by Alderson and colleagues included a total of 12,083 patients of all ages with clinically diagnosed traumatic brain injury, some of whom received steroid treatment within seven days of their injury.

The cause of death in patients who received steroid treatment in the new large trial was unclear, according the study’s authors. Some researchers have suggested that corticosteroids increase the likelihood of death by interfering with adrenal gland function.

This review appeared in the January issue of The Cochrane Library, a publication of the Cochrane Collaboration that evaluates medical research.

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A course of steroids may all that be required to help some women who have suffered repeated miscarriages or failed IVF treatments, as per a conference in Liverpool in the UK.

This research was presented at the British Association conference and suggested that many of the 3,000 unexplained miscarriages every year can be prevented with the use of steroids.

Dr. Siobhan Quenby, of the University of Liverpool and the Liverpool Women’s Hospital said that tests involving 120 women had ascertained natural killer cells as a cause of miscarriages and failed IVF embryo implants.

From News-Medical.Net:

Steroids prescribed to 40 women, who had suffered multiple miscarriages, resulted in three quarters of them successfully giving birth.

The steroid treatment has been shown to reduce the level of natural killer cells in the uterus, and this is thought to increase the chances of an embryo going to full term.

Dr. Quenby says currently there is no treatment for the thousands of women around the world who are desperate because they keep miscarrying for no reason.

She says there is a massive and desperate need for a treatment and suggests that a third of miscarriages could be prevented.

Dr. Quenby, in partnership with the Miscarriage Association, is looking for 40 women with a history of miscarriages and high levels of natural killer cells to take part in a trial.

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A new research by scientists at the University of Edinburgh has suggested that R-roscovitine, a drug presently being tested for treating cancer can help asthmatic patients to a considerable extent.

It was revealed that this drug can help in killing specific immune cells to exacerbate asthma symptoms. This finding is expected to offer an alternative way for treating asthma in steroid-resistant patients.

From Sciencedaily.com:

Professor Adriano Rossi, of the Centre for Inflammation Research at the University of Edinburgh who directed the study, said: “Steroids are commonly used to treat asthma but can have unwanted side-effects, while some asthma patients are also resistant to steroid treatment. It may well be that use of a drug, such as R-Roscovitine, or one that works in a similar same way, could offer an alternative to steroids, or be used in conjunction with steroid treatment for asthma patients.”

The research has been published in the journal FEBS Letters.

It was remarked by the involved researchers that usage of this drug caused the eosinophil cells to undergo a form of cell death known as apoptosis, which is a natural process wherein unwanted cells are removed from the human body.

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A new research at the University of Michigan’s Kresge Hearing Research Institute has brought hopes to thousands of patients who turned deaf due to an immune system attack.

The study may help patients in ascertaining if steroids can help them and also if they can be spared from harsh side effects of steroids.

From News-Medical.Net:

Of the eight study participants who had systemic autoimmune diseases and showed signs of antibodies against IESCA, six regained their hearing after steroid treatment.

Researchers at U-M have been studying IESCA for several years in animals and have found that it may be a main target of the immune system’s deafening attack on the inner ear.

IESCA is found in the supporting cells that help make up the organ of Corti, a tiny but crucial structure inside the cochlea, or inner ear.

It is here, inside the organ of Corti, that the ultra-sensitive hair cells are found.

According to senior author Thomas Carey, Ph.D., a professor and distinguished research scientist at the U-M Medical School and department chair in the School of Dentistry, the study results strongly suggest that an accurate prediction concerning the hope of patients for regaining hearing abilities with steroid treatment may be a possibility with a direct test for antibodies.

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According to a new study co-authored by Dr. Joan Bregstein of the Morgan Stanley Children’s Hospital of NewYork-Presbyterian and Columbia University Medical Center, steroid treatment is not effective for helping infants with a common and potentially serious viral lower respiratory infection called bronchiolitis.

It was revealed during the study that steroids do not prevent hospitalization or improve respiratory symptoms for bronchiolitis, which is considered to be the most common cause of infant hospitalization.

From News-Medical.Net:

“Our study shows that treating bronchiolitis with steroids doesn’t work. We hope this study will resolve some of the uncertainty for physicians and families, as we move forward in developing better means of preventing and treating the infection,” says Dr. Bregstein, site principal investigator and emergency medicine pediatrician at Morgan Stanley Children’s Hospital of NewYork-Presbyterian and assistant clinical professor of pediatrics at Columbia University College of Physicians and Surgeons.

Current recommendations suggest that simple supportive care is the best available treatment for bronchiolitis. Researchers note that steroid-based medications still play an important role in other respiratory illnesses of childhood such as asthma and croup. They point out these medications are not the androgenic steroids sometimes abused by athletes, and that the side effects seen with long-term steroid use are not a risk in the short-course treatments used for croup and asthma attacks.

This multicenter study was published in the July 26 New England Journal of Medicine and conducted by the Pediatric Emergency Care Applied Research Network (PECARN).

It was suggested that simple supportive care is the best treatment option for bronchiolitis though steroid-based medications play an important role in respiratory illnesses of childhood such as asthma and croup.

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R-roscovitine, a potential cancer drug, that is used to kill specific immune cells exacerbating asthma symptoms could also help patients suffering from asthma, according to a recently concluded research.

Scientists at the University of Edinburgh said that R-roscovitine can prove to be an effective alternative way for treating asthma in patients who show resistance to steroids that are commonly used in treatments related to asthma.

From Sciencedaily.com:

Researchers studied the effect that the drug had on immune cells known as eosinophils.

Eosinophils, found in the lungs and airways, help the body fight off parasitic infection. However, too many uncontrolled eosinophils can damage other cells that line the lung, contributing to inflammatory conditions such as asthma.

Researchers found that use of the drug caused the eosinophil cells to undergo a form of cell death known as apoptosis, a natural process where unwanted cells are removed from the body.

Professor Adriano Rossi, of the Centre for Inflammation Research at the University of Edinburgh who directed the study, remarked that steroids though useful for treating asthma can have some side effects. Moreover, some asthmatic patients are resistant to steroid treatment. This is where R-Roscovitine, an alternative to steroids, can be used in conjunction with steroid treatment for asthma patients.

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As per results of a recently concluded study, boys with Duchenne muscular dystrophy can walk for longer on their own after getting themselves treated with daily steroid treatment. It was also remarked during the study that steroid treatment can help them reduce the risk of scoliosis to a significant extent.

The results were part of a published study in an issue of Neurology, the scientific journal of the American Academy of Neurology.

From News-Medical.Net:

For the study, researchers reviewed records of 143 boys seen at the Ohio State University Muscular Dystrophy Clinic in Columbus. Of the group, 75 had been treated with corticosteroids for an average of eight years and the rest of the boys had never been treated or had received a brief dose of steroids.

The study found boys who were treated with daily steroids walked by themselves 3.3 years longer than the untreated boys and had a lower rate of scoliosis, 31 percent compared to 91 percent.

“Previous studies have shown steroids improve strength and function in Duchenne muscular dystrophy, but this is the first study to show the long-term impact and how treated boys are able to walk longer on their own,” said study author Wendy King, PT, with the Department of Neurology at Ohio State University Medical Center, and member of the American Academy of Neurology.

However, it was remarked that benefits of steroid treatment for boys with muscular dystrophy may come at the cost of some side effects and doctors must be highly careful while advising steroid treatment.

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According to a study that was published in an issue of Pediatrics, steroids can prove their real worth when it comes to reducing damage to the heart in children with Kawasaki’s disease.

This study was quick to highlight knowledge gap among members of the medical fraternity for treating Kawasaki’s disease since the present guidelines from the American Academy of Pediatrics suggest that there is little evidence for suggesting the effectiveness of steroids for treating children with Kawasaki’s disease and reducing damage to the heart.

Stephen Aronoff, MD, lead author of the meta-analysis and Temple University School of Medicine professor and chair of pediatrics, said that a multi-center study will be more than useful in justifying steroid treatment benefits for Kawasaki’s disease.

From News-Medical.Net:

“This gap in knowledge led us to examine the benefits of steroids more closely. We looked at research worldwide and were surprised to find eight solid clinical trials showing the value of steroids in significantly reducing heart damage in children with Kawasaki’s disease. Steroids, when combined with aspirin and IVGB, reduced the odds of developing inflammation of the heart blood vessels by half,” said Stephen Aronoff, MD, lead author of the meta-analysis and Temple University School of Medicine professor and chair of pediatrics.

The study also brought forward recommendations being made available for the standard treatment of Kawasaki’s via aspirin and intravenous immunoglobulin (IVIG).

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According to a study in an issue of Pediatrics, steroids can considerably minimize the odds of development of heart damage in children with Kawasaki’s disease. These findings address a serious gap in knowledge, as felt by some experts.

It is worth noting here that the present-day guidelines from the American Academy of  Pediatrics state that supporting evidence for steroid treatment is lacking. The Academy advocates the use of aspirin and intravenous immunoglobulin (IVIG) for treating Kawasaki’s disease.

From News-Medical.Net:

“This gap in knowledge led us to examine the benefits of steroids more closely. We looked at research worldwide and were surprised to find eight solid clinical trials showing the value of steroids in significantly reducing heart damage in children with Kawasaki’s disease. Steroids, when combined with aspirin and IVGB, reduced the odds of developing inflammation of the heart blood vessels by half,” said Stephen Aronoff, MD, lead author of the meta-analysis and Temple University School of Medicine professor and chair of pediatrics.

It was remarked by Aronoff that many more presently underway studies will provide further evidence of the advantages of steroid treatment along with guidelines for effective types and doses of steroids. These findings will help medical practitioners to be confident while prescribing steroids to their patients after a pros-and-cons study has been evaluated at the first place.

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