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Pioglitazone treatment of virally-infected smoke-exposed mice proved more efficacious than the steroid intervention.
We show that pioglitazone had greater efficacy in smoke-exposed influenza-infected mice when compared to the systemic steroid intervention.
While the steroid intervention failed to attenuate inflammation, we did observe a significantly worsened clinical presentation in mice early in the course of influenza infection (day five).
In addition, similar responses are observed for the system if it is pre-exposed to hypercortisolemia for 6 hr but the steroid intervention is initiated at t = −12 hr (CORT-6-LPS), Figure 10.
Although it is understood that treating the cytokine storm observed during an influenza infection with steroids is in-effective [22], [34], no studies to our knowledge involving models of cigarette smoke and virus have addressed if a steroid intervention would control the exacerbated responses observed in smokers.
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For the first patient group (n = 16) EDSS progression, number of steroid interventions and relapse rate two years before initiation of treatment were assessed retrospectively and compared to the first two years after start of treatment.
Since we showed that steroid interventions did not play a role in attenuating the inflammation observed in this model of cigarette smoke exposure and influenza infection, we examined whether another anti-inflammatory agent would attenuate the observed dysregulation in the inflammatory response.
The results of this meta-analysis are promising because the outcomes consistently favor the use of steroids interventions.
All analyses were done on an intention to treat basis, implying that no adjustments were made for the need for steroid treatment during the intervention period.
Five trials (10.4%) compared topical steroid against no intervention.
In two studies, 21 31 there were unequal co-interventions including steroid or non-steroidal anti-inflammatory drugs (NSAIDs) between the treatment groups.
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Justyna Jupowicz-Kozak
CEO of Professional Science Editing for Scientists @ prosciediting.com