Does budesonide affect immune system

Asthma is a common airway disease across the globe and mostly affect a person since young. It involves a cascade of immune system activation which causes repeated inflammation leading to constriction of the airway. The classical feature you can observe from an asthmatic person is the sharp, high-pitched wheezing sound when they are gasping for air. Unfortunately, the awareness of asthma is still low in Malaysia and there are still a lot of uncontrolled and undiagnosed asthma patients who do not receive the optimum treatment. Following the recently updated guidelines for asthma treatment, we can see that steroid is putting more on use as it is even recommended for patients with mild asthma, but people are reluctant to use it because they are afraid of compromisation of the immune system by the steroids. One of the famous examples of steroid is Budesonide which is incorporated into the inhaler known as Budecort. So, what is the impact of Budesonide on the immune system?

Like mentioned above, asthma symptoms are associated with the activation of body immune system. Budesonide is under the class of corticosteroid is able to suppress such activation, keeping the immune activity low so that the subsequent asthmatic attacks will not be triggered easily. However, if our immune system is chronically suppressed, we will be rendered a higher risk of getting an infection. It is important to keep an optimum dosage, especially for children as they are more prone to develop oral thrush (oral candidiasis) due to prolonged use of Budecort. Thus, frequent cleaning of the inhaler mouthpiece or the spacer and rinsing mouth after each use is recommended to clear off the excessive steroids and also can wash off the potential infective microorganisms. 

Budesonide can be absorbed into our system suppressing our immune system further. Invading microorganisms have a higher chance to survive in this immunocompromised state, exposing us to all sorts of systemic infection. Hence, individuals who are on Budesonide treatment should have their immune system status monitored during every routine checkup. While suppressing the immune system, Budesonide can also cause overactivity of the immune system in individuals who are allergic to corticosteroids. Symptoms such as rashes, hives, airway constriction or body swelling will arise once they come in contact with any form of steroids. Therefore, parents have to take notice of their children while using Budesonide inhaler and be aware of these symptoms so interventions can be done promptly. 

Budesonide is definitely an effective drug which is able to help the majority of the asthmatic patients. However, its side effects on our immune system can be devastating and cannot be ignored. As a user or caretaker of the user, we are responsible to be vigilant on the possible negative effects not only on the immune system, also on our bones and adrenal hormones, to make sure we get the most benefits out of this treatment.