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Biomarkers Predicting Response to Corticosteroid Therapy in Asthma

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Treatments in Respiratory Medicine

Abstract

International guidelines on the management of asthma support the early introduction of corticosteroids to control symptoms and to improve lung function by reducing airway inflammation. However, not all individuals respond to corticosteroids to the same extent and it would be an advantage to be able to predict the response to corticosteroid treatment. Several biomarkers have been assessed following treatment with corticosteroids including measures of lung function, peripheral blood and sputum indices of inflammation, exhaled gases and breath condensates. The most widely examined measures in predicting a response to corticosteroids are airway hyperresponsiveness, exhaled nitric oxide (eNO) and induced sputum. Of these, sputum eosinophilia has been demonstrated to be the best predictor of a short-term response to corticosteroids. More importantly, directing treatment at normalizing the sputum eosinophil count can substantially reduce severe exacerbations. The widespread utilization of sputum induction is hampered because the procedure is relatively labor intensive. The measurement of eNO is simpler, but incorporating the assessment of NO in an asthma management strategy has not led to a reduction in exacerbation rates. The challenge now is to either simplify the measurement of a sputum eosinophilia or to identify another inflammatory marker with a similar efficacy as the sputum eosinophil count in predicting both the short- and long-term responses to corticosteroids.

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References

  1. Wardlaw AJ, Brightling C, Green R, et al. Eosinophils in asthma and other allergic diseases. Br Med Bull 2000; 56(4): 985–1003

    Article  PubMed  CAS  Google Scholar 

  2. Brightling CE, Bradding P, Symon FA, et al. Mast-cell infiltration of airway smooth muscle in asthma. N Engl J Med 2002; 346(22): 1699–705

    Article  PubMed  Google Scholar 

  3. Kay AB. Pathology of mild, severe, and fatal asthma. Am J Respir Crit Care Med 1996; 154 (2 Pt 2): S66–9

    PubMed  CAS  Google Scholar 

  4. National Heart, Lung and Blood Institute. Global intiative for asthma: global strategy for asthma management and prevention. Bethesda, MD; 1995

  5. British Thoracic Society. Scottish Intercollegiate Guidelines Network (SIGN). British guidelines on the management of asthma. Thorax 2003; 58 Suppl. 1: i1–94

    Article  Google Scholar 

  6. Juniper EF, Kline PA, Vanzieleghem MA, et al. Long-term effects of budesonide on airway responsiveness and clinical asthma severity in inhaled steroid-dependent asthmatics. Eur Respir J 1990; 3(10): 1122–7

    PubMed  CAS  Google Scholar 

  7. Juniper EF, Kline PA, Vanzieleghem MA, et al. Effect of long-term treatment with an inhaled corticosteroid (budesonide) on airway hyperresponsiveness and clinical asthma in nonsteroid-dependent asthmatics. Am Rev Respir Dis 1990; 142(4): 832–6

    PubMed  CAS  Google Scholar 

  8. Haahtela T, Jarvinen M, Kava T, et al. Comparison of a beta 2-agonist, terbutaline, with an inhaled corticosteroid, budesonide, in newly detected asthma. N Engl J Med 1991; 325(6): 388–92

    Article  PubMed  CAS  Google Scholar 

  9. Adams NP, Bestall JB, Jones PW. Inhaled beclomethasone versus placebo for chronic asthma. Cochrane Database Syst Rev 2000; (4): CD002738

  10. Loren ML, Chai H, Leung P, et al. Corticosteroids in the treatment of acute exacerbations of asthma. Ann Allergy 1980; 45(2): 67–71

    PubMed  CAS  Google Scholar 

  11. Beasley R. The burden of asthma with specific reference to the United States. J. Allergy Clin Immunol 2002; 109 (5 Suppl.): S482–9

    Article  PubMed  Google Scholar 

  12. Crimi E, Spanevello A, Neri M, et al. Dissociation between airway inflammation and airway hyperresponsiveness in allergic asthma. Am J Respir Crit Care Med 1998; 157(1): 4–9

    PubMed  CAS  Google Scholar 

  13. Rosi E, Scano G. Association of sputum parameters with clinical and functional measurements in asthma. Thorax 2000; 55(3): 235–8

    Article  PubMed  CAS  Google Scholar 

  14. Ronchi MC, Piragino C, Rosi E, et al. Do sputum eosinophils and ECP relate to the severity of asthma? Eur Respir J 1997; 10(8): 1809–13

    Article  PubMed  CAS  Google Scholar 

  15. Veen JC, Smits HH, Ravensberg AJ, et al. Impaired perception of dyspnea in patients with severe asthma: relation to sputum eosinophils. Am J Respir Crit Care Med 1998; 158(4): 1134–41

    PubMed  CAS  Google Scholar 

  16. Roisman GL, Peiffer C, Lacronique JG, et al. Perception of bronchial obstruction in asthmatic patients: relationship with bronchial eosinophilic inflammation and epithelial damage and effect of corticosteroid treatment. J Clin Invest 1995; 96(1): 12–21

    Article  PubMed  CAS  Google Scholar 

  17. Salome CM, Reddel HK, Ware SI, et al. Effect of budesonide on the perception of induced airway narrowing in subjects with asthma. Am J Respir Crit Care Med 2002; 165(1): 15–21

    PubMed  Google Scholar 

  18. Parameswaran K, Pizzichini E, Pizzichini MM, et al. Clinical judgement of airway inflammation versus sputum cell counts in patients with asthma. Eur Respir J 2000; 15(3): 486–90

    Article  PubMed  CAS  Google Scholar 

  19. Reddel HK, Jenkins CR, Marks GB, et al. Optimal asthma control, starting with high doses of inhaled budesonide. Eur Respir J 2000; 16(2): 226–35

    Article  PubMed  CAS  Google Scholar 

  20. Gershman NH, Wong HH, Liu JT, et al. Low- and high-dose fluticasone propionate in asthma; effects during and after treatment. Eur Respir J 2000; 15(1): 11–8

    Article  PubMed  CAS  Google Scholar 

  21. Evans RM. The steroid and thyroid hormone receptor superfamily. Science 1988; 240(4854): 889–95

    Article  PubMed  CAS  Google Scholar 

  22. Carson-Jurica MA, Schrader WT, O’Malley BW. Steroid receptor family: structure and functions. Endocr Rev 1990; 11(2): 201–20

    Article  PubMed  CAS  Google Scholar 

  23. Gronemeyer H. Control of transcription activation by steroid hormone receptors. FASEB J 1992; 6(8): 2524–9

    PubMed  CAS  Google Scholar 

  24. Jonat C, Rahmsdorf HJ, Park KK, et al. Antitumor promotion and antiinflammation: down-modulation of AP-1 (Fos/Jun) activity by glucocorticoid hormone. Cell 1990; 62(6): 1189–204

    Article  PubMed  CAS  Google Scholar 

  25. Auphan N, Didonato JA, Rosette C, et al. Immunosuppression by glucocorticoids: inhibition of NF-kappa B activity through induction of I kappa B synthesis. Science 1995; 270(5234): 286–90

    Article  PubMed  CAS  Google Scholar 

  26. Djukanovic R, Wilson JW, Britten KM, et al. Effect of an inhaled corticosteroid on airway inflammation and symptoms in asthma. Am Rev Respir Dis 1992; 145(3): 669–74

    PubMed  CAS  Google Scholar 

  27. Ward C, Pais M, Bish R, et al. Airway inflammation, basement membrane thickening and bronchial hyperresponsiveness in asthma. Thorax 2002; 57(4): 309–16

    Article  PubMed  CAS  Google Scholar 

  28. Hoshino M, Nakamura Y, Sim JJ, et al. Inhaled corticosteroid reduced lamina reticularis of the basement membrane by modulation of insulin-like growth factor (IGF)-I expression in bronchial asthma. Clin Exp Allergy 1998; 28(5): 568–77

    Article  PubMed  CAS  Google Scholar 

  29. Hoshino M, Takahashi M, Takai Y, et al. Inhaled corticosteroids decrease vascularity of the bronchial mucosa in patients with asthma. Clin Exp Allergy 2001; 31(5): 722–30

    Article  PubMed  CAS  Google Scholar 

  30. Bentley AM, Hamid Q, Robinson DS, et al. Prednisolone treatment in asthma: reduction in the numbers of eosinophils, T cells, tryptase-only positive mast cells, and modulation of IL-4, IL-5, and interferon-gamma cytokine gene expression within the bronchial mucosa. Am J Respir Crit Care Med 1996; 153(2): 551–6

    PubMed  CAS  Google Scholar 

  31. Orsida BE, Li X, Hickey B, et al. Vascularity in asthmatic airways: relation to inhaled steroid dose. Thorax 1999; 54(4): 289–95

    Article  PubMed  CAS  Google Scholar 

  32. Knox AJ. The scientific rationale of combining inhaled glucocorticoids and long acting Beta 2 adrenoceptor agonists. Curr Pharm Des 2002; 8(20): 1863–9

    Article  PubMed  CAS  Google Scholar 

  33. Bjornson BH, Harvey JM, Rose L. Differential effect of hydrocortisone on eosinophil and neutrophil proliferation. J Clin Invest 1985; 76(3): 924–9

    Article  PubMed  CAS  Google Scholar 

  34. Meagher LC, Cousin JM, Seckl JR, et al. Opposing effects of glucocorticoids on the rate of apoptosis in neutrophilic and eosinophilic granulocytes. J Immunol 1996; 156(11): 4422–8

    PubMed  CAS  Google Scholar 

  35. Meijer RJ, Postma DS, Kauffman HF, et al. Accuracy of eosinophils and eosinophil cationic protein to predict steroid improvement in asthma. Clin Exp Allergy 2002; 32(7): 1096–103

    Article  PubMed  CAS  Google Scholar 

  36. Pavord ID, Brightling CE, Woltmann G, et al. Non-eosinophilic corticosteroid unresponsive asthma. Lancet 1999; 353(9171): 2213–4

    Article  PubMed  CAS  Google Scholar 

  37. Mondino C, Ciabattoni G, Koch P, et al. Effects of inhaled corticosteroids on exhaled leukotrienes and prostanoids in asthmatic children. J Allergy Clin Immunol 2004; 114(4): 761–7

    Article  PubMed  CAS  Google Scholar 

  38. Hunter CJ, Brightling CE, Woltmann G, et al. A comparison of the validity of different diagnostic tests in adults with asthma. Chest 2002; 121(4): 1051–7

    Article  PubMed  Google Scholar 

  39. Verscheiden P, Cartier A, L’Archeveque J, et al. Compliance with and accuracy of daily self-assessment of peak expiratory flows (PEF) in asthmatic subjects over a three month period. Eur Respir J 1996; 9(5): 880–5

    Article  Google Scholar 

  40. Diner B, Brenner B, Camargo CA, et al. Inaccuracy of “personal best” peak expiratory flow rate reported by inner-city patients with acute asthma. J Asthma 2001; 38(2): 127–32

    Article  PubMed  CAS  Google Scholar 

  41. Reddel HK, Toelle BG, Marks GB, et al. Analysis of adherence to peak flow monitoring when recording of data is electronic. BMJ 2002; 324(7330): 146–7

    Article  PubMed  Google Scholar 

  42. Reddel H, Ware S, Marks G, et al. A. Differences between asthma exacerbations and poor asthma control. Lancet 1999; 353(9150): 364–9

    CAS  Google Scholar 

  43. Reddel H, Jenkins C, Woolcock A. Diurnal variability—time to change asthma guidelines? BMJ 1999; 319(7201): 45–7

    Article  PubMed  CAS  Google Scholar 

  44. Birring SS, Heartin E, Williams TJ, et al. Peak expiratory flow sequence in acute exacerbations of asthma. BMJ 2001; 322(7297): 1281

    Article  PubMed  CAS  Google Scholar 

  45. Juniper EF, Cockcroft DW, Hargreave FE. Histamine and methacholine inhalation tests: a laboratory tidal breathing protocol. Lund: Astra Draco AB, 1994

    Google Scholar 

  46. Crapo RO, Casaburi R, Coates AL, et al. Guidelines for methacholine and exercise challenge testing-1999. This official statement of the American Thoracic Society was adopted by the ATS Board of Directors, July 1999. Am J Respir Crit Care Med 2000; 161(1): 309–29

    PubMed  CAS  Google Scholar 

  47. Barnes PJ. Effect of corticosteroids on airway hyperresponsiveness. Am Rev Respir Dis 1990; 141 (2 Pt 2): S70–6

    PubMed  CAS  Google Scholar 

  48. Vathenen AS, Knox AJ, Wisniewski A, et al. Time course of change in bronchial reactivity with an inhaled corticosteroid in asthma. Am Rev Respir Dis 1991; 143(6): 1317–21

    PubMed  CAS  Google Scholar 

  49. Boulet LP, Turcotte H, Brochu A. Persistence of airway obstruction and hyperresponsiveness in subjects with asthma remission. Chest 1994; 105(4): 1024–31

    Article  PubMed  CAS  Google Scholar 

  50. Leuppi JD, Salome CM, Jenkins CR, et al. Predictive markers of asthma exacerbation during stepwise dose reduction of inhaled corticosteroids. Am J Respir Crit Care Med 2001; 163(2): 406–12

    PubMed  CAS  Google Scholar 

  51. Sont JK, Willems LN, Bel EH, et al. Clinical control and histopathologic outcome of asthma when using airway hyperresponsiveness as an additional guide to long-term treatment. The AMPUL Study Group. Am J Respir Crit Care Med 1999; 159 (4 Pt 1): 1043–51

    PubMed  CAS  Google Scholar 

  52. Green RH, Brightling CE, Woltmann GW, et al. Analysis of induced sputum in adults with asthma: identification of a subgroup with neutrophilic inhaled corticosteroid resistant disease. Thorax 2002; 57: 875–9

    Article  PubMed  CAS  Google Scholar 

  53. Pizzichini E, Pizzichini MM, Efthimiadis A, et al. Measuring airway inflammation in asthma: eosinophils and eosinophilic cationic protein in induced sputum compared with peripheral blood. J Allergy Clin Immunol 1997; 99(4): 539–44

    Article  PubMed  CAS  Google Scholar 

  54. Baba K, Hattori T, Koishikawa I, et al. Serum eosinophil cationic protein for predicting the prognosis of a step-down in inhaled corticosteroid therapy in adult chronic asthmatics. J Asthma 2000; 37(5): 399–408

    Article  PubMed  CAS  Google Scholar 

  55. Baba K, Sakakibara A, Yagi T, et al. Long-term observations of the clinical course after step down of corticosteroid inhalation therapy in adult chronic asthmatics: correlation with serum levels of eosinophil cationic protein. Respirology 2002; 7(3): 255–66

    Article  PubMed  Google Scholar 

  56. Prehn A, Seger RA, Torresani T, et al. Evaluation of a clinical algorithm involving serum eosinophil cationic protein for guiding the anti-inflammatory treatment of bronchial asthma in childhood. Pediatr Allergy Immunol 2000; 11(2): 87–94

    Article  PubMed  CAS  Google Scholar 

  57. Bosse M, Chakir J, Rouabhia M, et al. Serum matrix metalloproteinase-9: tissue inhibitor of metalloproteinase-1 ratio correlates with steroid responsiveness in moderate to severe asthma. Am J Respir Crit Care Med 1999; 159(2): 596–602

    PubMed  CAS  Google Scholar 

  58. Schedin U, Frostell C, Persson MG, et al. Contribution from upper and lower airways to exhaled endogenous nitric oxide in humans. Acta Anaesthesiol Scand 1995; 39(3): 327–32

    Article  PubMed  CAS  Google Scholar 

  59. Kharitonov SA, Yates D, Robbins RA, et al. Increased nitric oxide in exhaled air of asthmatic patients. Lancet 1994; 343(8890): 133–5

    Article  PubMed  CAS  Google Scholar 

  60. Persson MG, Zetterstrom O, Agrenius V, et al. Single-breath nitric oxide measurements in asthmatic patients and smokers. Lancet 1994; 343(8890): 146–7

    Article  PubMed  CAS  Google Scholar 

  61. Hamid Q, Springall DR, Riveros-Moreno V, et al. Induction of nitric oxide synthase in asthma. Lancet 1993; 342(8886-8887): 1510–3

    Article  PubMed  CAS  Google Scholar 

  62. Saleh D, Ernst P, Lim S, et al. Increased formation of the potent oxidant peroxynitrite in the airways of asthmatic patients is associated with induction of nitric oxide synthase: effect of inhaled glucocorticoid. FASEB J 1998; 12(11): 929–37

    PubMed  CAS  Google Scholar 

  63. Kharitonov SA, Yates DH, Barnes PJ. Inhaled glucocorticoids decrease nitric oxide in exhaled air of asthmatic patients. Am J Respir Crit Care Med 1996; 153(1): 454–7

    PubMed  CAS  Google Scholar 

  64. Massaro AF, Gaston B, Kita D, et al. Expired nitric oxide levels during treatment of acute asthma. Am J Respir Crit Care Med 1995; 152(2): 800–3

    PubMed  CAS  Google Scholar 

  65. Kharitonov SA, Yates DH, Chung KF, et al. Changes in the dose of inhaled steroid affect exhaled nitric oxide levels in asthmatic patients. Eur Respir J 1996; 9(2): 196–201

    Article  PubMed  CAS  Google Scholar 

  66. Jatakanon A, Lim S, Barnes PJ. Changes in sputum eosinophils predict loss of asthma control. Am J Respir Crit Care Med 2000; 161(1): 64–72

    PubMed  CAS  Google Scholar 

  67. Little SA, Chalmers GW, MacLeod KJ, et al. Non-invasive markers of airway inflammation as predictors of oral steroid responsiveness in asthma. Thorax 2000; 55(3): 232–4

    Article  PubMed  CAS  Google Scholar 

  68. Smith AD, Cowan J, Brasset KP, et al. Use of exhaled nitric oxide measurements to guide treatment in chronic asthma. N Engl J Med 2005; 352(21): 2163–73

    Article  PubMed  CAS  Google Scholar 

  69. Zacharasiewicz A, Wilson N, Lex C, et al. Clinical use of non-invasive measurements of airway inflammation in steroid reduction in children. Am J Respir Crit Care Med 2005; 171: 1077–82

    Article  PubMed  Google Scholar 

  70. Zayasu K, Sekizawa K, Okinaga S, et al. Increased carbon monoxide in exhaled air of asthmatic patients. Am J Respir Crit Care Med 1997; 156 (4 Pt 1): 1140–3

    PubMed  CAS  Google Scholar 

  71. Lim S, Groneberg D, Fischer A, et al. Expression of heme oxygenase isoenzymes 1 and 2 in normal and asthmatic airways: effect of inhaled corticosteroids. Am J Respir Crit Care Med 2000; 162(5): 1912–8

    PubMed  CAS  Google Scholar 

  72. Olopade CO, Zakkar M, Swedler WI, et al. Exhaled pentane levels in acute asthma. Chest 1997; 111(4): 862–5

    Article  PubMed  CAS  Google Scholar 

  73. Paredi P, Kharitonov SA, Barnes PJ. Faster rise of exhaled breath temperature in asthma: a novel marker of airway inflammation? Am J Respir Crit Care Med 2002; 165(2): 181–4

    PubMed  Google Scholar 

  74. Kharitonov SA, Barnes PJ. Exhaled markers of inflammation. Curr Opin Allergy Clin Immunol 2001; 1(3): 217–24

    PubMed  CAS  Google Scholar 

  75. Pavord ID, Pizzichini MM, Pizzichini E, et al. The use of induced sputum to investigate airway inflammation. Thorax 1997; 52(6): 498–501

    Article  PubMed  CAS  Google Scholar 

  76. Fahy JV, Liu J, Wong H, et al. Cellular and biochemical analysis of induced sputum from asthmatic and from healthy subjects. Am Rev Respir Dis 1993; 147(5): 1126–31

    PubMed  CAS  Google Scholar 

  77. Gibson PG, Girgis-Gabardo A, Morris MM, et al. Cellular characteristics of sputum from patients with asthma and chronic bronchitis. Thorax 1989; 44(9): 693–9

    Article  PubMed  CAS  Google Scholar 

  78. Pizzichini E, Pizzichini MM, Leigh R, et al. Safety of sputum induction. Eur Respir J Suppl 2002; 37: 9S–18S

    PubMed  CAS  Google Scholar 

  79. Paggiaro PL, Chanez P, Holz O, et al. Sputum induction. Eur Respir J Suppl 2002; 37: 3S–8S

    PubMed  CAS  Google Scholar 

  80. Djukanovic R, Sterk PJ, Fahy JV, et al. Standardised methodology of sputum induction and processing. Eur Respir J Suppl 2002; 37: 1S–2S

    Article  PubMed  CAS  Google Scholar 

  81. Maestrelli P, Saetta M, Di Stefano A, et al. Comparison of leukocyte counts in sputum, bronchial biopsies, and bronchoalveolar lavage. Am J Respir Crit Care Med 1995; 152 (6 Pt 1): 1926–31

    PubMed  CAS  Google Scholar 

  82. Fahy JV, Wong H, Liu J, et al. Comparison of samples collected by sputum induction and bronchoscopy from asthmatic and healthy subjects. Am J Respir Crit Care Med 1995; 152(1): 53–8

    PubMed  CAS  Google Scholar 

  83. Belda J, Leigh R, Parameswaran K, et al. Induced sputum cell counts in healthy adults. Am J Respir Crit Care Med 2000; 161 (2 Pt 1): 475–8

    PubMed  CAS  Google Scholar 

  84. Claman DM, Boushey HA, Liu J, et al. Analysis of induced sputum to examine the effects of prednisone on airway inflammation in asthmatic subjects. J Allergy Clin Immunol 1994; 94(5): 861–9

    Article  PubMed  CAS  Google Scholar 

  85. Gibson PG, Simpson JL, Saltos N. Heterogeneity of airway inflammation in persistent asthma: evidence of neutrophilic inflammation and increased sputum interleukin-8. Chest 2001; 119(5): 1329–36

    Article  PubMed  CAS  Google Scholar 

  86. Wenzel SE, Schwartz LB, Langmack EL, et al. Evidence that severe asthma can be divided pathologically into two inflammatory subtypes with distinct physiologic and clinical characteristics. Am J Respir Crit Care Med 1999; 160(3): 1001–8

    PubMed  CAS  Google Scholar 

  87. Brightling CE, Monteiro W, Ward R, et al. Sputum eosinophilia and short-term response to prednisolone in chronic obstructive pulmonary disease: a randomised controlled trial. Lancet 2000; 356(9240): 1480–5

    Article  PubMed  CAS  Google Scholar 

  88. Pizzichini E, Pizzichini MM, Gibson P, et al. Sputum eosinophilia predicts benefit from prednisone in smokers with chronic obstructive bronchitis. Am J Respir Crit Care Med 1998; 158 (5 Pt 1): 1511–7

    PubMed  CAS  Google Scholar 

  89. Pizzichini MM, Pizzichini E, Parameswaran K, et al. Nonasthmatic chronic cough: no effect of treatment with an inhaled corticosteroid in patients without sputum eosinophilia. Can Respir J 1999; 6(4): 323–30

    PubMed  CAS  Google Scholar 

  90. Godon P, Boulet LP, Malo JL, et al. Assessment and evaluation of symptomatic steroid-naive asthmatics without sputum eosinophilia and their response to inhaled corticosteroids. Eur Respir J 2002; 20(6): 1364–9

    Article  PubMed  CAS  Google Scholar 

  91. Pizzichini MM, Pizzichini E, Clelland L, et al. Sputum in severe exacerbations of asthma: kinetics of inflammatory indices after prednisone treatment. Am J Respir Crit Care Med 1997; 155(5): 1501–8

    PubMed  CAS  Google Scholar 

  92. Giannini D, Di Franco A, Cianchetti S, et al. Analysis of induced sputum before and after withdrawal of treatment with inhaled corticosteroids in asthmatic patients. Clin Exp Allergy 2000; 30(12): 1777–84

    Article  PubMed  CAS  Google Scholar 

  93. Green RH, Brightling CE, McKenna S, et al. Reduced asthma exacerbations with a management strategy directed at normalising the sputum eosinophil count. Lancet 2002; 360: 1715–21

    Article  PubMed  Google Scholar 

  94. Lane SJ, Lee TH. Mononuclear cells in corticosteroid-resistant asthma. Am J Respir Crit Care Med 1996; 154 (2 Pt 2): S49–51

    PubMed  CAS  Google Scholar 

  95. Sher ER, Leung DY, Surs W, et al. Steroid-resistant asthma. Cellular mechanisms contributing to inadequate response to glucocorticoid therapy. J Clin Invest 1994; 93(1): 33–9

    Article  PubMed  CAS  Google Scholar 

  96. Chakir J, Hamid Q, Bosse M, et al. Bronchial inflammation in corticosteroid-sensitive and corticosteroid-resistant asthma at baseline and on oral corticosteroid treatment. Clin Exp Allergy 2002; 32(4): 578-82

    Article  PubMed  CAS  Google Scholar 

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  1. Institute for Lung Health, University of Leicester and University Hospitals of Leicester, Groby Road, Leicester, LE3 9QP, UK

    Christopher E. Brightling, Ruth H. Green & Ian D. Pavord

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Brightling, C.E., Green, R.H. & Pavord, I.D. Biomarkers Predicting Response to Corticosteroid Therapy in Asthma. Treat Respir Med 4, 309–316 (2005). https://doi.org/10.2165/00151829-200504050-00002

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