This paper is only available as a PDF. To read, Please Download here.
Abstract
Airway hypersecretion is mediated by increased release of inflammatory mediators and can be improved by inhibition of mediator production. We have recently reported that 1.8-cineol (eucalyptol) which is known as the major monoterpene of eucalyptus oil suppressed arachidonic acid metabolism and cytokine production in human monocytes. Therefore, the aim of this study was to evaluate the anti-inflammatory efficacy of 1.8-cineol by determining its prednisolone equivalent potency in patients with severe asthma. Thirty-two patients with steroid-dependent bronchial asthma were enrolled in a double-blind, placebo-controlled trial. After determining the effective oral steroid dosage during a 2 month run-in phase, subjects were randomly allocated to receive either 200 mg 1.8-cineol t.i.d. or placebo in small gut soluble capsules for 12 weeks. Oral glucocorticosteroids were reduced by 2.5 mg increments every 3 weeks. The primary end point of this investigation was to establish the oral glucocorticosteroid-sparing capacity of 1.8-cineol in severe asthma. Reductions in daily prednisolone dosage of 36% with active treatment (range 2.5–10 mg, mean: 3.75 mg) vs. a decrease of only 7% (2.5–5 mg, mean: 0.91 mg) in the placebo group ( P=0.006) were tolerated. Twelve of 16 cineol vs. four out of 16 placebo patients achieved a reduction of oral steroids (P=0.012). Long-term systemic therapy with 1.8-cineol has a significant steroid-saving effect in steroid-depending asthma. This is the first evidence suggesting an anti-inflammatory activity of the monoterpene 1.8-cineol in asthma and a new rational for its use as mucolytic agent in upper and lower airway diseases.
Keywords
References
REFERENCES
- Structure–activity relationships for inhibition of prostaglandin cyclooxygenase by phenolic compounds.Prostaglandins. 1980; 20: 209-222
- Pathogenesis of airway mucus hypersecretion.J Allergy Clin Immunol. 1990; 85: 399-419
- Slow-reacting substances, leukotrienes C4 and D4, increase the release of mucus from human airways in vitro.Am Rev Respir Dis. 1982; 126: 449-451
- Inhibition of cytokine production and arachidonic acid metabolism by eucalyptol (1.8-cineol) in human blood monocytesin vitro.Eur J Med Res. 1998; 3: 508-510
- Steroid-like inhibition of monocyte arachidonic acid metabolism and IL-1 β production by eucalyptol (1.8-cineol) (in German).Atemw-Lungenkrkh. 1998; 24: 3-11
- Therapy with expectorants: a double-blind randomised study comparing ambroxol and cineol (in German).Atemw-Lungenkrkh. 1998; 24: 67-74
- Comparison of secretolytics Change of ciliary frequency and lung function after therapy with cineol and ambroxol (in German).Z Atemweg/Lungenerkr. 1994; 20: 605-614
- Anti-inflammatory effects of eucalyptol (1.8-cineol) in bronchial asthma: inhibition of arachidonic acid metabolism in human blood monocytes ex vivo.Eur J Med Res. 1998; 3: 407-412
National Asthma Education and Prevention Program, 2, Bethesda (MD), NIH/ National Heart, Lung, and Blood Institute; April 1997
- Antiinflammatory and antinociceptive effects of 1.8-cineol a terpenoid oxide present in many plant essential oils.Phytother Res. 2000; 14: 240-244
- The anti-inflammatory activity of L-menthol compared to mint oil in human monocytes in vitro: a novel perspective for its therapeutic use in inflammatory diseases.Eur J Med Res. 1998; 3: 539-545
- Effect of menthol vapour on airway hyperresponsiveness in patients with mild asthma.Respir Med. 1995; 89: 503-504
- Human airway mono-hydroxyeicosatetraenoic acid generation and mucus release.J Clin Invest. 1983; 72: 122-127
- Effects of prostaglandins E1, E2, and F2 α on mucin secretion from human bronchi in vitro.Thorax. 1984; 39: 420-423
Article info
Publication history
Accepted:
August 12,
2002
Received:
May 28,
2002
Identification
Copyright
© 2003 Elsevier Science Ltd. Published by Elsevier Inc.
User license
Elsevier user license | How you can reuse 
Elsevier's open access license policy
Elsevier user license
Permitted
For non-commercial purposes:
- Read, print & download
- Text & data mine
- Translate the article
Not Permitted
- Reuse portions or extracts from the article in other works
- Redistribute or republish the final article
- Sell or re-use for commercial purposes
Elsevier's open access license policy
