Effects of fluticasone propionate on inflammatory cells in COPD: an ultrastructural examination of endobronchial biopsy tissue.

Abstract

BACKGROUND:

Inhaled corticosteroids (ICS) markedly reduce bronchial mucosal inflammation in asthma but whether they have an anti-inflammatory effect in airway tissue in chronic obstructive pulmonary disease (COPD) is unknown.

METHODS:

A study of endobronchial biopsy samples was conducted as part of a double blind, placebo controlled, randomised trial of parallel design. Patients had mild to moderately severe COPD (FEV(1) 25-80% of predicted) and were given 3 months treatment with ICS, fluticasone propionate (FP; 500 micro g twice daily, n=14) or placebo (n=10). Biopsy tissue taken at baseline and after treatment was examined by transmission electron microscopy to count the numbers of all ultrastructurally distinct inflammatory cells.

RESULTS:

Compared with their baseline values, FP resulted in a significant decrease (on average 65%) in the numbers of mucosal mast cells (median 7.8 (range 1-33) v 2.8 (1-14), p<0.05). The reductive effect of FP held true when the post-treatment values of the placebo and FP groups were compared: 8.8 (1-24) v 2.8 (1-14) (p<0.05). Unexpectedly, there were significantly more neutrophils in the FP than in the placebo group: 4.0 (0-23) v 1.7 (0-8), respectively (p<0.05). There were no alterations to other cell types including mononuclear cells. Symptoms markedly improved in the patients treated with FP for 3 months.

CONCLUSION:

Fluticasone propionate given for 3 months to patients with COPD has selective effects on the inflammatory cells in the bronchial mucosa: the reduction in mast cell numbers may account for the improvement in symptoms over this time.

• Authors: M J Gizycki, K L Hattotuwa, N Barnes, P K Jeffery
• Journal: Thorax (Thorax) Vol. 57 Issue 9 Pg. 799-803 (Sep 2002) ISSN: 0040-6376 [Print] England
• PMID: 12200525 (Publication Type: Clinical Trial, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Androstadienes
• Bronchodilator Agents
• Fluticasone

Topics

• Aged
• Androstadienes (therapeutic use)
• Biopsy (methods)
• Bronchi (drug effects, ultrastructure)
• Bronchitis (drug therapy, pathology)
• Bronchodilator Agents (therapeutic use)
• Double-Blind Method
• Female
• Fluticasone
• Forced Expiratory Volume (physiology)
• Humans
• Male
• Pulmonary Disease, Chronic Obstructive (drug therapy, pathology, physiopathology)
• Vital Capacity (physiology)