| 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
(Affiliation: Lung Pathology Unit, Imperial College School of Medicine at the Royal Brompton Hospital, London, UK London Chest Hospital, London, UK.)
|
| Journal | Thorax
(Thorax)
Vol. 57
Issue 9
Pg. 799-803
(Sep 2002)
ISSN: 0040-6376 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
- Forced Expiratory Volume
(physiology)
- Humans
- Male
- Pulmonary Disease, Chronic Obstructive
(drug therapy, pathology, physiopathology)
- Vital Capacity
(physiology)
|
