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Steroids to treat asthma: How safe are they?

Date:
February 24, 2011
Source:
Université de Montréal
Summary:
Children experiencing an asthma attack who are treated with a short burst of oral steroids may have a brief and transient depression of immune response, according to a new study. These findings have implications for asthmatic children who have flare-ups and who may be exposed to new contagious diseases.

Children experiencing an asthma attack who are treated with a short burst of oral steroids may have a brief and transient depression of immune response, according to a new study led by Université de Montréal. These findings, published in this month's issue of Pediatric Allergy, Immunology and Pulmonology, have implications for asthmatic children who have flare-ups and who may be exposed to new contagious diseases.

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"There is no question that the administration of corticosteroids reduces the risk and duration of hospital admission in children with acute asthma and remains the most effective treatment for moderate and severe asthma exacerbations," says first author Francine M. Ducharme, a Université de Montréal professor and pediatrician and researcher at the Sainte-Justine University Hospital Research Center. "However, the safety profile of these medications continues to raise concerns among parents and physicians. Concerns over their possible impact on the immune system stem from few rare reports linking or severe chickenpox infections linked with corticosteroid administration."

Reduced immune response to new triggers

Ducharme and colleagues evaluated the immune response of children aged 3 to 17 years, who had arrived at the emergency department (ED) with an asthma attack. All subjects were given immune triggers (known as antigens) and the immune response between those who received corticosteroids versus those who did not were compared.

"Several corticosteroid-treated children had a lower immune response, as measured by the amount of antibody produced, than non-treated kids," says Ducharme.

Reduced immunity only transient

Children enrolled in the study were re-vaccinated with the antigen five weeks following their initial ED visit. Comparable immune responses were measured in children exposed to oral corticosteroids and not exposed to corticosteroids.

"These findings indicate there may be a very transient immune suppression only in some children exposed to a new antigen at the same time as a corticosteroid administration," says Ducharme.

"In summary, our findings suggest a very transient immune suppression occurs in some children who are concomitantly exposed to a new antigen and corticosteroids during an asthma attack, with a recovery within six weeks."

"Given the high frequency of use of these drugs over the past 20 years, the very rare occurrence of severe infectious disease is reassuring and would suggest that the window of risk is very small and only applies to exposure to a new antigen. However, before prescribing oral corticosteroids, it would appear prudent to systematically enquire about recent exposure to chickenpox in children who did not have chickenpox or the vaccine," adds Ducharme. Moreover, all children with asthma who have not had chickenpox should be vaccinated for this condition.


Story Source:

The above story is based on materials provided by Université de Montréal. Note: Materials may be edited for content and length.


Journal Reference:

  1. Francine M. Ducharme, Hans D. Ochs, Sandy Resendes, Xun Zhang, Bruce D. Mazer. A Short Burst of Oral Corticosteroid for Children with Acute Asthma: Is There an Impact on Immunity? Pediatric Allergy, Immunology, and Pulmonology, 2010; 23 (4): 243 DOI: 10.1089/ped.2010.0041

Cite This Page:

Université de Montréal. "Steroids to treat asthma: How safe are they?." ScienceDaily. ScienceDaily, 24 February 2011. <www.sciencedaily.com/releases/2011/02/110223181039.htm>.
Université de Montréal. (2011, February 24). Steroids to treat asthma: How safe are they?. ScienceDaily. Retrieved November 1, 2014 from www.sciencedaily.com/releases/2011/02/110223181039.htm
Université de Montréal. "Steroids to treat asthma: How safe are they?." ScienceDaily. www.sciencedaily.com/releases/2011/02/110223181039.htm (accessed November 1, 2014).

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