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ICS favors long-term outcome in childhood asthma

ICS favors long-term outcome in childhood asthma. Dr. Gautam Sadhukhan. INFLAMMATION. INDUCERS Maternal smoking, Chemicals, Air pollutants, Virus infections. Inhaled CORTICOSTEROIDS. Genetic propensity. Airway Hyperresponsiveness. Airflow Limitation. TRIGGERS Allergens, Exercise

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ICS favors long-term outcome in childhood asthma

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  1. ICS favors long-term outcome in childhood asthma Dr. Gautam Sadhukhan Dr. G.Ghosh & Dr. G.Sadhukhan

  2. INFLAMMATION INDUCERS Maternal smoking, Chemicals, Air pollutants, Virus infections Inhaled CORTICOSTEROIDS Genetic propensity Airway Hyperresponsiveness Airflow Limitation TRIGGERS Allergens, Exercise Cold Air, SO2 Particulates SYMPTOMS Dr. G.Ghosh & Dr. G.Sadhukhan

  3. Superimposed acute inflammation Chronic inflammation Airway remodeling Structural changes Time Inflammation in asthma ICS Dr. G.Ghosh & Dr. G.Sadhukhan

  4. PEP Talk Natural history of asthma 2 out of 3 children with asthma outgrow their symptoms Risk factors for asthma persisting into adulthood • Female • Eczema • Onset after age of 3 years • Severe disease • Parental history of atopy / asthma Dr. G.Ghosh & Dr. G.Sadhukhan

  5. Methacholine Challenge Test CAMP study; NEJM 2000 Methach. Requ. To Produce Fall In FEV1 ICS Placebo Airway Hyper responsiveness Time : 4 to 6 years Dr. G.Ghosh & Dr. G.Sadhukhan

  6. M’Lord & H’able Juries • ICS specifically inhibit inflammation so long it is used!(NHLBI & GINA Studies, 1997-2002) • Airway hyper-responsiveness.: Definite improvement (CAMP study; NEJM 2000) • All wheezers improve in both acute and chronic symptoms. (Martinez FD ; Pediatrics 2002). • Airway remodelling: may be preventable if ICS are used in right time and duration (Bisgaard. H. Am J Resp Care 1996) Dr. G.Ghosh & Dr. G.Sadhukhan

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