Budesonide reduces sensitivity and reactivity to inhaled mannitol in asthmatic subjects

Respirology. 2002 Mar;7(1):37-44. doi: 10.1046/j.1440-1843.2002.00357.x.


Objective: The aim of the study was to investigate whether treatment using inhaled corticosteroids decreases airway responsiveness to inhaled mannitol in asthmatic subjects.

Methodology: Before treatment or a change in treatment with inhaled corticosteroids, 18 asthmatic subjects had measurements of lung function and airway sensitivity to mannitol taken and they completed a self-administered questionnaire on asthma symptoms. The procedure was repeated 6-9 weeks after taking 800-2400 microg/day of budesonide.

Results: There were significant reductions in airway sensitivity (provoking dose to induce a 15% fall in FEV1 (PD15)) and airway reactivity measured by the response dose ratio (RDR; final percentage fall FEV1/total dose of mannitol administered). The PD15 (Gmean (95%CI)) increased from 78 mg (51, 117) before treatment to 289 mg (202, 414) following treatment (P < 0.001). All subjects had a significant increase beyond the repeatability of 0.9 doubling doses with seven subjects becoming unresponsive. There was a 4.2 (3.4, 4.9)-fold improvement in the RDR with the value before the treatment period 0.18 (0.12, 0.28) decreasing to 0.04 (0.03, 0.08) following treatment (P < 0.001). These improvements were associated with significant improvements in lung function and symptom severity.

Conclusion: Treatment with the inhaled corticosteroid budesonide caused a decrease in airway sensitivity and reactivity to inhaled mannitol and this was associated with expected improvements in lung function and symptoms.

Publication types

  • Comparative Study

MeSH terms

  • Administration, Inhalation
  • Adult
  • Asthma / diagnosis
  • Asthma / drug therapy*
  • Asthma / physiopathology
  • Bronchial Hyperreactivity / drug therapy*
  • Bronchial Hyperreactivity / etiology
  • Bronchial Provocation Tests
  • Bronchodilator Agents / administration & dosage*
  • Bronchodilator Agents / therapeutic use
  • Budesonide / administration & dosage*
  • Budesonide / therapeutic use
  • Female
  • Forced Expiratory Volume / drug effects
  • Humans
  • Male
  • Mannitol* / adverse effects
  • Middle Aged
  • Pilot Projects
  • Time Factors


  • Bronchodilator Agents
  • Mannitol
  • Budesonide