• Journal of Yeungnam Medical Science
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• 제5권2호
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• pp.95-100
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• 1988

Ipratropium bromide(IP) is a new anticholinergic bronchodilator To evaluate its effect on bronchial asthma which is still unkown in Korea, a double blind and randomized study was done on all patients of bronchial asthma who visit out-patients clinic of our department from June to September 1987 and showed 75 to 100% of FEV1 / FVC ratio (On pre bronchodilator spirometry(pre BD). The selected patients were given 2 puffs of Fenoterol(FE) or Ipratropium inhalator blindly and Spirometry The repeated results are: 1. In both FE and IP groups, there was a significant bronchodilatory effect on 5 and 60 minutes after administration. 2. On 5 minutes, effect of FE was significantly greater than IP.(FVC p<0.05, FEV1 p<0.01) 3. On 60 minutes, effect of IP was slightly less than FE but statistically non-significant. On the basis of above results, we concluded that onset of effect of IP is slower than FE, but its effect is significant and nearly comparable to FE.

• Tuberculosis and Respiratory Diseases
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• 제58권5호
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• pp.498-506
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• 2005

연구배경 : 본 연구는 COPD환자를 대상으로 기관지확장제인 tiotropium 1일 1회, 1회 1캅셀 $18{\mu}g$과 ipratropium 1일 4회, 1회 2퍼프(퍼프당 $20{\mu}g$)의 유효성 및 안전성을 비교 평가하고자 하였다. 방 법 : 초기 선별방문 후, 환자는 2주간의 관찰기간에 들어갔으며, 이 기간을 마친 환자는 이중맹검, 무작위배정 하에 위약과 함께 1일 1회 tiotropium 또는 1일 4회 ipratropium을 투여 받았다. 유효성평가는 폐기능검사, 일중 PEFR측정, 환자평가 설문조사, 보조치료약물(살부타몰) 사용량으로 하였다. 폐기능검사는 치료시작 시(0일), 치료 14일후와 치료종료 시(28일)에 하였는데, 이때 투약 5분 전, 투약 후 30분, 60분, 120분 및 180분에 시행하였다. 결 과 : 16개 기관에서 134명의 환자가 분석되었다. 환자의 평균 (표준편차) 나이는 66 (7)세이었고 $FEV_1$은 예측치의 42 (12)%였다. 4주 치료 후 trough $FEV_1$ 반응은 ipratropium군에 비해 tiotropium군에서 유의하게 높았으며 PEFR경우에도 4주 동안 지속적으로 아침 흡입 전 측정한 PEFR이 tiotropium군에서 높게 나타났다(차이: 12.52-13.88 l/min). 4주 치료 기간동안 tiotropium은 좋은 내약성과 함께, ipratropium과 유사한 안전성을 나타냈다. 결 론 : 1일 1회 흡입용 항콜린제제인 tiotropium이 1일 4회 흡입용제제인 ipratropium에 비해 COPD환자를 치료하는데 더 우수한 기관지확장 반응을 보여주었고 안전성에서는 유사하였다.

• Biomolecules & Therapeutics
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• 제17권4호
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• pp.388-394
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• 2009

The cytokines which is produced by allergen-specific T helper (Th) cells play a pivotal role in the pathogenesis of asthma. Asthma is caused by exaggerated T-helper 2 (Th2)-based immune responses. It is suggested that controlling such Th2-based response is necessary for asthma therapy. The current therapies for asthma focus primarily on control of symptoms and suppression of inflammation, without affecting the underlying cause. So, we examined that anti-asthmatic drugs might have play a certain role in Th2/Th1 balance. Splenocytes isolated from ovalbumin (OVA)-sensitized mice cultured with anti-asthmatic drugs. It is well known that Th2 and Th1 immune responses can balance one another, as Th2 mediators suppress Th1 responses and Th1 mediators similarly inhibit Th2 responses. But salmeterol inhibits both of Th1 and Th2 mediators, which salmeterol is a suppressor of immune responses not only a suppressor of Th2-based immune responses. Aminophylline is a weak suppressor of immune responses. But ipratropium and cromoglycate don't have any suppressor effect to Th2-driven responses. They only have suppressor effect to Th1 immune responses. Salmeterol, ipratropium, aminophylline, and cromoglycate augmented mRNA levels of CRTH2, EP2, and IP2 receptors in OVA-sensitized splenocytes. It is well known that the up-regulation of CRTH2 - $PGD_2$ receptor - results in restraint of eosinophil recruitment and that the increment of IP and EP2 - $PGI_2$ and $PGE_2$ receptor, respectively - may induce the accumulation of cAMP that decrease the effector function of T cells. Moreover salmeterol and cromoglycate increase the mRNA expression of $PGD_2$ synthase. These findings indicate that anti-asthma agents may alleviate the immunological responses that cause the asthmatic diseases.

• Clinical and Experimental Pediatrics
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• 제49권6호
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• pp.593-601
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• 2006

Allergic rhinitis is a common disease of childhood characterized by nasal, throat, and ocular itching, rhinorrhea, sneezing, nasal congestion. Those affected with allergic rhinitis often suffer from associated inflammatory conditions of the mucosa, such as allergic conjunctivitis, rhinosinusitis, asthma, otitis media with effusion, and other atopic conditions, such as eczema and food allergies. Allergic rhinitis must be diagnosed and treated properly to prevent complications and impaired quality of life. Despite a high prevalence, allergic rhinitis isoften undiagnosed and inadequately treated, especially in the pediatric population. The first step in treatment is environmental control when appropriate. It may be difficult to eliminate all offending allergens effectively to reduce symptoms, so medications are often required. Many different classes of medications are now available, and they have been shown to be effective and safe in a large number of well-designed, clinical trials. Antihistamines are effective in treating immediate symptoms of sneezing, pruritus, watery eyes, and rhinorrhea. Second generation antihistamines are the preferred antihistamines because of their superior side effect profile. Thus, decongestants are commonly used with oral antihistamines. Intranasal corticosteroids are the most effective therapy for allergic rhinitis. Leukotriene modifier may be as effective as antihistamines in treating allergic rhinitis symptoms. Cromolyn sodium is an option for mild disease when used prophylactically, and ipratropium bromide is effective when rhinorrhea is the predominant symptom. When avoidance measures and medications are not effective, specific immunotherapy is an effective alternative. Only immunotherapy results in sustained changes in the immune system. Because of improved understanding of the pathogenesis, new and better therapies may be forthcoming. The effective treatment of allergic rhinitis in children will reduce symptoms and will improve overall health and quality of life, making a happier, healthier child.