Asthama is a chronic inflammatory disorder of the airway with recurrent airflow obstruction. Chronic airway inflammation is invariably associated with injury and repair of the bronchial epithelium, which results in structural and functional changes known as remodeling Inflammation, remodeling, and altered neural control of the airway are responsible for both recurrent exacerbations of asthma and more permanent airflow obstruction. Asthma exacerbations may be caused by a variety of risk factors including allergens, pollutants, foods and drugs. Prevention of exacerbation aims to reduce the exposure to these risk factors to improve the control of asthma and reduce medication needs. Although no cure for asthma has yet been found, it is resonable to expect that in most patients with asthma, control of the disease can and should be achieved and maintained. Patient education involves a understanding of why and how to manage asthma and how to prevent asthma exacerbation. Medications for asthma can be administered in different ways, including inhaled, oral and parenteral. The major advantage of delivering drugs directly into the airways via inhalation is that high concentrations can be delivered more effectively to the airways, and systemic side effects are avoided or minimized. Therapy should be selected on the basis of the severity of a patient's asthma. According to the GINA guideline 2002, for intermittent asthma, no daily medication is reconmmended for the vast majority of patients. A rapid-acting inhaled β2-agonist may be taken as needed to relieve asthma symptoms. The occasional patient with intermittent asthma, but severe exacerbations, should be treated as having moderate persistent asthma. Patients with mild persistent asthma require controller medication every day to achieve and maintain control of their asthma. Treatment with an inhaled glucocorticosteroid is preferred. Sustained-relase theophyline cromolynes or a leukotriene modifier are other options. The preferred therapy for moderate persistent asthma is regular treatment with a combination of inhaled glucocorticosteroid and a long-acting inhaled glucocorticosteroid and a long-acting inhaled β2-agonist twice daily. Sustained-release theophyline or a leukotriene modifier are alternatives to the β2-agonist in this combination therapy. An alternative to combination therapy is a higher dose of inhaled glucocorticosteriod. The primary therapy for severe persistent asthma includes inhaled steroids at higher doses plus a long acting inhaled β2-agonist twice daily. Any available medications including oral steroid may be added to control asthma symptoms. Once control of asthma is achieved and maintained for at least 3 months, a gradual reduction of the maintenance therapy should be tried.
Allergens ; Asthma* ; Cromolyn Sodium ; Epithelium ; Humans ; Inflammation ; Inhalation ; Patient Education as Topic ; Risk Factors ; Steroids

OBJECTIVES: Although DSCG protects against the stimuli of various bronchoconstictor, such as exercise, it is not effective to all patients. There seems to be no therapeutic predictor that determines effectiveness of DSCG on bronchial asthma. Although it is commonly assumed that children with predominantly allergic asthma have a better response to DSCG therapy than adult patient, this has not been convincingly demonstrated, and even adult with late onset nonallergic asthma may benefit. In this study, we evaluated the factors that potentially influenced the ability of DSCG to reduce bronchial hyperresponsibility. METHODS: The treatment groups were sub-divide into effective group(n=14) and ineffective group(n=6) on the basis of significant improvement of followedup PC20 after long term therapy of DSCG. We compared clinical and laboratory data and pulmonary function test between two groups. RESULTS: 1) Disease durtion and pre-treatment pulmonary function (FEV1% predicted, FVC% predicted value) may play a role in determining effectiveness of DSCG on bronchial asthma(p<0.05). 2) Allergic rhinitis history seems to have been associated with effectiveness of DSCG(p<0,05). But this findings was not clearly demonstrated the association of atopic status because skin test, eosinophil count, serum IgE level were not significant difference between two groups(p>0.05). CONCLUSION: These results show that DSCG is effective in adult chronic asthma and early administration of DSCG, good pulmonary function test and allergic rhinitis history may lead to more favorable outcome.
Adult ; Asthma* ; Child ; Cromolyn Sodium ; Eosinophils ; Humans ; Immunoglobulin E ; Respiratory Function Tests ; Rhinitis ; Skin Tests

BACKGROUND: The purpose of the present study was to determine the protective effect of antiasthmatic activity of inhaled heparin, cromolyn sodium, budesonide, furosemide in exercise-induced asthma(EIA). The other important considerable point of this study was the mechanism of bronchoconstriction on EIA. METHOD: Eight subjects with a history of EIA were studied on 5 different experiment days. After obtaining baseline FEV(1) and FVC, subjects performed a standardized exercise challenge. EIA was assessed by measurement of FEV(1) before and after exercise. On experiment day 4, the exercise challengs was performed after the subjects inhaled either heparin (1,000 units/kg/day for 5 days), furosemide (1 mg/kg for 5 days), cromolyn(4 mg/kg for 5 days), or budesonide (400 micrograms/day for 5 days). On experiment day 5, the methacholine brochial provocation test was performed. On experiment day 3, activated partial thromboplastine time(aPTT) was checked. RESULTS: Maximum decrements of FEV(1)(mean+/-SE) among o to 120 minutes after exerise were as follows : heparin was 83.1+/-4.81% (p=0.010), furosemide was 80.5+/-6.87% (p=0.071), cromolyn was 86.8+/-6.53% (p=0.340), and budesonide was 79.4+/-7.31% (p=0.095). Above medications were copmpared to the control value (72.5+/-18.2%) by paired t-test. No medications had effect on PD of methacholine bronchial provocation test. The results were control (1.58+/-0.49 mumol), heparin(4.17+/-1.96 mumol), forosemide (1.85+/-0.86 mumol), cromolyn (2.19+/-0.89 mumol) and budesonide (3.38+/-1.77 mumol), respectively(p>0.05). The inhaled heparin had no effect of anticoagulation. CONCLUSION: These data demonstrate that inhaled heparin has a protective effect on EIA. The effect of inhaled cromolyn was statisitically absent with manufacture's recommended dosage on EIA. So, the dosage of cromolyn should be carefully evaluated in future. Although inhalation of budesonide and furosemide have no statistical significance compared to control, these drugs also have some protective effects on EIA.
Asthma, Exercise-Induced* ; Bronchial Provocation Tests ; Bronchoconstriction ; Budesonide* ; Cromolyn Sodium* ; Furosemide* ; Heparin* ; Inhalation ; Methacholine Chloride ; Thromboplastin

BACKGROUND/AIMS: Ulcerative colitis (UC) is a type of inflammatory bowel disease that mainly involves the colon. Thus far, glucocorticoids and amino-salicylate have been the main treatment.METHODS: To assess drugs with fewer side effects, this study evaluated the effects of sodium cromoglycate (SCG) on acetic acid-induced UC in rats. The treatment groups included SCG receivers (50 and 100 mg/kg, intra-orally) and sulfasalazine (SSZ) receivers (100 mg/kg, intra-orally). The colonic mucosal injury was assessed by clinical, macroscopic, and histopathological examinations.RESULTS: In the treatment groups with 50 and 100 mg/kg of SCG, the clinical activity score decreased to 2.67±0.18 and 1.73±0.21 (p<0.05), respectively, compared to the UC control group (3.21±0.31), and were higher than that of the group given the standard treatment of 100 mg/kg SSZ (1.10±0.09). The treatment groups with 50 and 100 mg/kg of SCG showed a lower clinical gross lesion score than the UC control group (2.91±0.28 and 2.10±0.43, vs. 4.49±0.61, p<0.05) and were higher than the standard group (0.95±0.18). Treatment with SCG (100 mg/kg) decreased the macroscopic scores significantly compared to the UC control group (p<0.05) on the 8th day.CONCLUSIONS: SCG (100mg/kg) decreased significantly the clinical activity score, gross lesion, and percentage-affected area compared to the UC controls on the 8th day.
Acetic Acid ; Animals ; Colitis, Ulcerative ; Colon ; Cromolyn Sodium ; Glucocorticoids ; Inflammatory Bowel Diseases ; Mice ; Rats ; Sodium ; Sulfasalazine ; Ulcer

There are few reports on aggravation of asthma by mint flavor although it is a common ingredient of many products. A 40-year-old male patient with aspirin-sensitive asthma experienced anaphylaxis after using a gargle that contained mint flavor. Skin prick tests and ELISA for serum specific IgE to mint showed negative responses. Challenge tests with mint oil and menthol were positive and the immediate bronchoconstriction was completely inhibited by premedication with cromolyn sodium. These findings suggest that mast cells may be involved in the pathogenesis of mint-induced asthma or anaphylaxis. To our knowledge, this is the first case of mint-induced anaphylaxis. It is important to alert physicians to the possibility of aggravation of asthmatic symptoms or the development of anaphylaxis by mint flavor.
Adult ; Anaphylaxis* ; Asthma ; Bronchoconstriction ; Cromolyn Sodium ; Enzyme-Linked Immunosorbent Assay ; Humans ; Immunoglobulin E ; Male ; Mast Cells ; Mentha* ; Menthol ; Premedication ; Skin

BACKGROUND: Human seminal plasma (HSP)-induced hypersensitivity is one of the serious complications with sexual intercourse. The clinical manifestations of HSP-induced hypersensitivity may be related to the release of vasoactive mediators from mast cell induced by HSP. It has recently been reported that HSP modulates immune systems and induces mast cell degranulation and histamine release from rat peritoneal mast cells (RPMC). Ketotifen and disodium cromoglycate (DSCG), anti-asthmatic and anti-allergic drugs, have a role of mast cell stabilization and inhibit mast cell-induced leukocyte rolling and adhesion. But the inhibitory agents of HSP-induced mast cell activation are unknown. This study was performed to investigate the effects of DSCG and ketotifen on the HSP-induced mast cell activation. METHODS: For this, influences of DSCG and ketotifen on the human seminal plasma-induced degranulation, histamine release and morphological changes of RPMC were observed. RESULTS: The mast cell degranulation and histamine release of RPMC by HSP were induced in a dose-dependent fashion. The HSP-induced cytomorphological changes such as swelling, intracellular vacoules, and interrupted cell boundary were significantly inhibited by pretreatment with DSCG or ketotifen. DSCG and Ketotifen inhibited the HSP-induced degranulation and histamine release from RPMC. CONCLUSION: From the above results, it is suggested that DSCG and ketotifen have a inhibitory effect of the HSP-induced mast cell activation. DSCG and ketotifen may be used for treatment of HSP-induced hypersensitivity.
Animals ; Coitus ; Cromolyn Sodium* ; Histamine ; Histamine Release ; Humans* ; Hypersensitivity ; Immune System ; Ketotifen* ; Leukocyte Rolling ; Mast Cells* ; Rats ; Semen

Asthma is one of the most common allergic diseases in children. As a result of the advances in immunology and the studies of BAL and lung biopsy, the definition of asthma has been changed as a 'chronic inflammatory disorder of the airways'. Therefore pharmacologic therapy of asthma is focused on the control of allergic inflammation. According to its purpose, the asthma medication could be classified into two groups, that is, quick-relief agents and long-term control agents. Quick-relief agents give a prompt relief of acute symptoms (coughing, wheezing, difficulty of breathing, and chest tightness) and prevent exercise-induced bronchospasm. Short-acting inhaled β2-agonist is at present the most effective quick-relief agent. Long-term control agents are taken daily and chronically (for a long period of time) to maintain the control of persistent asthma and to prevent exacerbations, and include inhaled corticosteroid, cromolyn sodium, and others. A stepwise approach is recommended for treating a child with asthma to attain and maintain asthma control. Medications should be carefully chosen according to the severity of asthma and age of children.
Allergy and Immunology ; Asthma* ; Asthma, Exercise-Induced ; Biopsy ; Child ; Cromolyn Sodium ; Humans ; Inflammation ; Lung ; Respiration ; Respiratory Sounds ; Respiratory Therapy ; Thorax

OBJECTIVETo investigate the role of sodium cromoglycate in brain protection and its effects on brain tumor necrosis factor-alpha (TNF-alpha) and interleukin-1beta (IL-1beta) expressions after global cerebral ischemia-reperfusion (IR) injury in gerbils.

METHODSTwenty-four healthy male gerbils were randomized into 3 equal groups, namely the sham-operated group with isolation of the bilateral carotid arteries but without occlusion, IR injury model group with bilateral carotid artery occlusion, and sodium cromoglycate treatment group with bilateral carotid artery occlusion and sodium cromoglycate administration at 25 mg/kg via the lingual vein as soon as the reperfusion start with another dose 1 h later. The animals were then sacrificed and the thalamus were removed, fixed in 10% formaldehyde and sliced for observation under light microscope with HE staining. The rest brain tissues were prepared into homogenate to determine the content of TNF-alpha and IL-1beta. The right hemispheres of the gerbils were measured for wet weight and dry weight to calculate the water content in the brain.

RESULTSThe water content in the brain of the gerbils in the model group was the highest among the groups, and that in sodium cromoglycate treatment group was significantly less than that of the model group (P<0.05). Microscopic examination showed the most severe brain tissue damage in the model group with also the highest TNF-alpha and IL-1beta levels in the brain. The brain TNF-alpha and IL-1beta levels in sodium cromoglycate group were significantly decreased as compared with those in the model group (P<0.05).

CONCLUSIONSodium cromoglycate can alleviate brain IR injury possibly by lowering the TNF-alpha and IL-1beta levels in the brain tissues.

Animals ; Brain Ischemia ; metabolism ; Cromolyn Sodium ; pharmacology ; Gerbillinae ; Interleukin-1beta ; metabolism ; Male ; Neuroprotective Agents ; pharmacology ; Random Allocation ; Reperfusion Injury ; prevention & control ; Tumor Necrosis Factor-alpha ; metabolism

Ulcerative colitis is an inflammatory disorder that affects the rectum and extends proximally to affect a variable extent of the colon. The major symptoms of ulcerative colitis include diarrhea, rectal bleeding, the passage of mucus, and abdominal pain. Ulcer-ative colitis also may be complicated by many local and systemic disorders as extrain-testinal manifestations. Pyoderma gangrenosum is the most severe dermatologic com-plication associated with ulcerative colitis. It is a painful , chronic, ulcerating skin disease of unknown cause. Diagnosis is clinical, there being no accepted histological diagnostic criteria. Conventional therapy is empirical, usually with high dose corticosteroids, but var-ious other agents have been tried with occasional success including topical antibiotics, cyclosporine, disodium cromoglycate, and dapsone. This patient was treated with high dose corticosteroid (prednisolone 1 mg/kg/day) and discharged with clinical improvement. So we report this case with a literature review.
Abdominal Pain ; Adrenal Cortex Hormones ; Anti-Bacterial Agents ; Colitis ; Colitis, Ulcerative* ; Colon ; Cromolyn Sodium ; Cyclosporine ; Dapsone ; Diagnosis ; Diarrhea ; Hemorrhage ; Humans ; Mucus ; Pyoderma Gangrenosum* ; Pyoderma* ; Rectum ; Skin Diseases ; Ulcer*

Mesangial IgA nephropathy was experimentally induced in ddY mice by oral and parenteral administration of the poliomyelitis vaccine (POLIO), and we then tried to investigate if IgA deposition could be prevented by the concurrent use of sodium cromoglycate (SCG), which is known to inhibit the local mucosal immune reaction. Mucosal and systemic immunity could be induced by the administration of POLIO; proteinuria, increased serum IgA levels, mesangial cell proliferation, mesangial matrix widening, mesangial deposits of IgA, and large electron dense deposits in the mesangium were observed. Concurrent administration of SCG and POLIO resulted in a significant decrease in the serum IgA level and mesangial IgA deposits. The later addition or abstinence of SCG after the 70th day did not influence the glomerular mesangial IgA deposition. But the serum IgA level was still decreased by the continuous treatment of SCG even after the 70th day. Thus, mesangial IgA nephropathy simulating IgA nephropathy in humans could be induced in ddY mice using POLIO and its induction could largely be prevented by the concurrent use of SCG. However mesangial IgA deposits already present could not be cleared by the late administration of SCG.
Animal ; Cromolyn Sodium/*pharmacology ; Female ; Fluorescent Antibody Technique ; Glomerulonephritis, IGA/*immunology/metabolism/pathology ; Immunoglobulin A/metabolism ; Mice ; Microscopy, Electron ; Poliovirus Vaccine, Inactivated/*immunology