MedWire News: Results from an Indian study suggest that
treatment with the lipotropic agent choline may help reduce
inflammation and oxidative stress in patients with asthma.
Previous studies have shown that choline, which is involved in
maintaining cell structure and the movement of fats in and out of
the cells, helps reduce inflammation in patients with arthritis and
in an allergen-induced animal model of inflammation, explain
Shailendra Gaur (University of Delhi) and colleagues in the journal
Immunobiology.
To investigate the effects of choline on immune inflammation and
bronchial hyper-responsiveness (BHR) in asthma patients, the
researchers recruited 76 patients aged 15-45 years.
The participants were assigned to receive 6 months of treatment
with oral choline chloride 1500 mg twice daily plus standard
pharmacotherapy (n=38) or standard pharmacotherapy alone (n=38).
Standard pharmacotherapy consisted of inhaled steroids and
long-acting beta-agonists twice daily, and short-acting
beta-agonists were used when required.
BHR was assessed at baseline and 6 months using the histamine
challenge test - the concentration of histamine needed to provoke a
20% fall in FEV1 (PC20). Blood samples were
collected at baseline and 6 months and assessed for levels of
immuno-biochemical markers. The participants also kept daily
diaries to record respiratory symptoms and medication use and were
assigned symptom and drug scores at the end of the study
period.
In total, 30 patients in the choline plus standard
pharmacotherapy group and 26 in the pharmacotherapy alone group
completed the 6-month study.
The researchers found that mean symptom scores fell from 94 at
baseline to 41 at 6 months in the choline plus pharmacotherapy
group and from 83 to 53 in the pharmacotherapy alone group. The
reduction in symptoms was significant in both groups, but the
between-group differences were not.
Mean drug scores changed from 112 at baseline to 84 at 6 months
in the choline plus pharmacotherapy group and from 120 to 138 in
the pharmacotherapy alone group. The change in drug scores was
significant in the choline group but not in the pharmacotherapy
alone group.
BHR decreased significantly over the study period in the choline
group but not in pharmacotherapy alone group. Indeed, at 6 months,
10 patients in the choline group required more than a 10-fold
increase in histamine concentration to provoke a 20% fall in
FEV1 compared with at baseline, while no patient in the
pharmacotherapy alone group achieved such improvements.
Patients in the choline group also had significantly greater
reductions in levels of the inflammatory mediators interleukin
(IL)-4, IL-5, and tumor necrosis factor-alpha than those in the
pharmacotherapy-alone group after 6 months, whereas similar
significant reductions in both groups were observed for eosinophil
and total immunoglobulin levels.
Patients in the choline group experienced significantly greater
reductions in levels of cysteinyl leukotriene and leukotriene B4
than those in pharmacotherapy-alone group, and these reductions
were accompanied by decreased 8-isoprostane levels - a biomarker
for oxidative stress.
Gaur and team conclude: "Choline administration for 6 months
suppresses immune inflammation and oxidative stress in asthma
patients. The results suggest that choline exerts anti-inflammatory
effect on the airways and reduces BHR in asthmatics.
"However, further studies are warranted to elucidate its
mechanism and subsequent investigations of choline in severe forms
of asthma."
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Springer Healthcare Limited. © Springer Healthcare Ltd;
2010
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