Focus & Scope

A summary of Evaluation of Asthma Control in Children Using Childhood-Asthma Control Test (CACT) and Asthma Therapy Assessment Questionnaire (ATAQ)

AR Somashekar*, KG Ramakrishnan

Department of Pediatrics, MS Ramaiah Medical College and Hospitals, Bengaluru, Karnataka, India

Fluticasone Furoate: A Once Daily Preparation in Patients with Persistent Asthma

Paul A. Lilburn¹*, Henry Ainge-Allen¹, Paul S. Thomas^1,2

¹Department of Respiratory Medicine, Prince of Wales’ Hospital

²Prince of Wales’ Clinical School and Mechanisms of Disease and Translational Research, University of New South Wales, NSW, Faculty of Medicine, University of New South Wales, NSW, Australia

Asthma affects approximately 240 million people worldwide. It is characterised by an allergic pattern of smooth muscle constriction and airway inflammation, and if chronic, the inflammation can lead to structural changes and fixed airflow obstruction. Bronchodilators relieve the bronchoconstriction, while inhaled corticosteroids reduce the airway inflammation. This paper reviews fluticasone furoate (FF), a novel inhaled corticosteroid with 24-hour duration of action. It is a synthetic fluorinated corticosteroid with agonist activity at the glucocorticoid receptor (GRE). It is reported to have a fast association and slow dissociation from the GRE compared to other ICSs. FF has been found to have a greater lung retention time than all other ICS preparations which may contribute to the extended duration of anti-inflammatory action. FF has extensive first pass hepatic metabolism resulting in a low gastrointestinal bioavailability which is consistent with the findings for other ICS preparations. FF, however, will pass from the lung into the systemic circulation and therefore an adverse profile similar to all ICS is likely, but long term data are needed.

FF has demonstrated treatment efficacy for asthma between 100μg and 200μg alone, but in combination with the long-acting beta agonist, vilanterol (FF/VIL 200μg/50μg OD) there were further improvements in lung function relative to monotherapy. There is an increased risk of pneumonia identified in patients with airways disease in associated with ICS preparations and surveillance will be required to determine if this also applies to FF. Once daily therapy, such as FF, may improve compliance and could hopefully be translated into further improvements in asthma-related outcomes.

Commentary: Novel Insight into the Genetic Basis of High Altitude Pulmonary Hypertension in Kyrgyz Highlanders

Tsering Stobdan¹ and Gabriel G. Haddad^{1, 2, 3}*

¹Division of Respiratory Medicine, Department of Pediatrics, University of California, San Diego, La Jolla, CA 92093, USA

²Department of Neurosciences, University of California, San Diego, La Jolla, CA 92093, USA

³Rady Children's Hospital, San Diego, CA 92123, USA

Complement Factor (C3) Level as Marker of Inflammation in Paediatric Asthma

AR Somashekar¹*, KG Ramakrishnan¹, Vanitha Gowda²

¹Department of Pediatrics, M.S. Ramaiah Medical College and hospitals, Bangalore, India

²Department of Biochemistry, M.S. Ramaiah Medical College and hospitals, Bangalore, India

Aim: To assess the serum levels of a complement factors C3 in Indian asthmatic children and compare them with those of healthy controls in order to establish a relationship between the levels of these factors and asthma disease process.

Method: Serum c3 levels of 44 children with acute asthma and 44 controls of the age group of 6-16 years was determined and statistically compared. Lung function tests (FEV1%) was done and correlated with serum c3 levels using Pearson’s comparison coefficient.

Results: The mean serum c3 value of cases (138±32.99) is higher than the controls (112.82±14.6), with 32% cases showing higher than normal level of serum C3. Pearson’s correlation coefficient reveals negative correlation between FEV1% with serum C3 levels.

Conclusion: This study reveals that serum levels of complement c3 are statistically higher in subjects with asthma as compared to healthy subjects. Further, serum levels of c3 reflect the severity of the disease, with its levels being higher when disease is more severe.