The dose-response relationship for ICS in terms of modifying underlying airways inflammation has also been determined. While most studies have attempted to investigate this issue through measurement of surrogate markers, including inflammatory cells in sputum or exhaled gases, these are indirect indices of uncertain relevance (51,52). A more informative method has been to investigate the nature and magnitude of airways inflammation through the detailed assessment of bronchial biopsies. Utilizing this approach, Wallin et al. (53) found no significant difference in markers of airway inflammation between a dose of 400 mg and 1000 mg/day of FP. This finding was derived from the measurement of submucosal mast cell and eosinophil numbers in bronchial mucosal biopsies after 12 weeks of
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