Asthma diagnosis and treatmentTreatment of asthma with nebulized lidocaine: A randomized, placebo-controlled study☆
Section snippets
Subject selection
Fifty subjects were recruited from the Rochester, Minnesota, area (18 male and 32 female subjects) who satisfied the inclusion criteria: 18 to 65 years of age, American Thoracic Society criteria for asthma (allergic or nonallergic),13 prebronchodilator FEV1 of 64% to 125% of predicted normal value, and daily treatment with inhaled glucocorticoids (triamcinolone, flunisolide, beclomethasone, or fluticasone) and bronchodilators (β2-agonists, theophylline, or ipratropium) for a minimum of 2
Results
Table I summarizes the subjects' characteristics at the beginning of the study (baseline). The treatment groups had similar median values for age, FEV1 in liters, FEV1 percent predicted, methacholine PD20, daily inhaled glucocorticoid use level in micrograms, nighttime awakenings, and number of blood eosinophils. Symptom scores and bronchodilator use were significantly greater in the lidocaine-treated group. The length of prior inhaled glucocorticoid use was comparable between the groups; the
Discussion
Prior uncontrolled studies of adults10 and children11., 12. with severe asthma requiring systemic glucocorticoids showed that nebulized lidocaine is a safe and effective steroid-sparing treatment. In this randomized, placebo-controlled study, nebulized lidocaine replaced inhaled glucocorticoids in subjects with mild-to-moderate asthma; its effects on pulmonary function, symptom scores, and blood eosinophils were comparable with those of glucocorticoids. This study was double blind, but when
Acknowledgements
We thank C. E. Reed, MD, for assistance in the design of this study and C. Adolphson and L. Arneson for preparation of the manuscript.
References (31)
- et al.
The effect of cortisone on bronchial asthma and hay fever occurring in subjects sensitive to ragweed pollen
J Allergy
(1950) - et al.
Plasma levels of lidocaine following nebulized aerosol administration
Chest
(1977) - et al.
Effect of nebulized lidocaine on severe glucocorticoid-dependent asthma
Mayo Clin Proc
(1996) - et al.
Nebulized lidocaine in the treatment of severe asthma in children: a pilot study
Ann Allergy Asthma Immunol
(1999) - et al.
Lidocaine nebulization for treatment of asthma
Ann Allergy Asthma Immunol
(2000) - et al.
The response to lidocaine in bronchial asthma
Chest
(1977) - et al.
Lidocaine-induced bronchoconstriction in asthmatic patients. Relation to histamine airway responsiveness and effect of preservative
Chest
(1989) - et al.
Effect of single doses of inhaled lignocaine on FEV1 and bronchial reactivity in asthma
Respir Med
(1998) - et al.
Combined lidocaine and salbutamol inhalation for airway anesthesia markedly protects against reflex bronchoconstriction
Chest
(2000) - et al.
Adrenocorticotropic hormone; adrenocortical steroids and their synthetic analogs; inhibitors of the synthesis and actions of adrenocortical hormones
Effects of glucocorticosteroids on inflammatory cells relevant to their therapeutic applications in asthma
Am Rev Respir Dis
Glucocorticoids inhibit cytokine-mediated eosinophil survival
J Immunol
Glucocorticoids inhibit eosinophil responses to granulocyte-macrophage colony-stimulating factor
J Immunol
Lidocaine in bronchoalveolar lavage fluid (BALF) is an inhibitor of eosinophil-active cytokines
Clin Exp Immunol
Lidocaine and its analogues inhibit IL-5-mediated survival and activation of human eosinophils
J Immunol
Cited by (82)
Design concepts of half-sandwich organoruthenium anticancer agents based on bidentate bioactive ligands
2021, Coordination Chemistry ReviewsNebulized Lidocaine in COVID-19, An Hypothesis
2020, Medical HypothesesFeline Asthma: Diagnostic and Treatment Update
2020, Veterinary Clinics of North America - Small Animal PracticeNebulized lidocaine ameliorates allergic airway inflammation via downregulation of TLR2
2018, Molecular ImmunologyCitation Excerpt :For the first time, our results served as evidence that TLR2 may be involved in the anti-inflammatory effect of lidocaine. Recent preliminary studies have shown that nebulized lidocaine reduces the use of oral glucocorticoids in patients with severe asthma (Hunt et al., 1996; Decco et al., 1999; Rosario et al., 2000; Hunt et al., 2004). In addition, lidocaine has been effectively utilized in the treatment of a pregnant woman with steroid-insensitive asthma (Saito et al., 2006).
Effects of lidocaine on regulatory T cells in atopic dermatitis
2016, Journal of Allergy and Clinical Immunology
- ☆
Supported by grants from the National Institutes of Health, AI 34577, and from the Mayo Foundation.