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Intraluminal inflammation in the airways of patients with chronic bronchitis after treatment with Ambroxol.

Abstract
Ambroxol is a mucus-modifying drug with a known ability to stimulate surfactant secretion and inhibit, in vitro, the production of proinflammatory cytokines, neutrophil chemotaxis, and Na+ absorption by the airway epithelium. In dogs inhaling ozone, bronchial hyperreactivity can be inhibited by aerosolized Ambroxol. To verify the possibility of producing anti-inflammatory effects in a clinically relevant condition, 20 patients with chronic bronchitis, randomly divided into two balanced matched groups, were submitted to a 14 day trial with Ambroxol, 150 mg.day-1, or placebo, according to a double-blind design. A bronchoalveolar lavage (BAL) was performed the day before starting treatment (T0) and at the 14th day (T14). The analysis of the cellular and soluble (total proteins, albumin, immunoglobulin G and A (IgG and IgA)) BAL components demonstrated no clear modifications. In particular, neutrophil values from the bronchial aliquot showed a large dispersion, with no significant differences (Ambroxol: T0 = 13.7 +/- 5.2%, T14 = 14.0 +/- 6.8%; placebo: T0 = 3.6 +/- 1.1%, T14 = 5.5 +/- 2.2%). We found a nonsignificant increase of phospholipids in BAL supernatants from Ambroxol-treated patients (2.5 +/- 1.9 vs 3.0 +/- 1.9 micrograms.mg-1 of protein); whilst in the placebo group data before and after treatment were superimposable (2.2 +/- 1.5 vs 2.3 +/- 1.9 micrograms.mg-1 of protein). In conclusion, we have failed to demonstrate that conventional treatment with oral Ambroxol can modify surfactant and BAL cell populations in the airways of patients with chronic bronchitis.
AuthorsM Lusuardi, A Capelli, M Salmona, M T Tacconi, C G Cerutti, C F Donner
JournalMonaldi archives for chest disease = Archivio Monaldi per le malattie del torace (Monaldi Arch Chest Dis) Vol. 50 Issue 5 Pg. 346-51 (Oct 1995) ISSN: 1122-0643 [Print] Italy
PMID8541815 (Publication Type: Clinical Trial, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
Chemical References
  • Expectorants
  • Ambroxol
Topics
  • Ambroxol (therapeutic use)
  • Bronchi (metabolism, pathology)
  • Bronchitis (drug therapy, metabolism, pathology)
  • Bronchoalveolar Lavage Fluid (chemistry, cytology)
  • Chronic Disease
  • Double-Blind Method
  • Expectorants (therapeutic use)
  • Female
  • Humans
  • Inflammation (pathology)
  • Male
  • Middle Aged

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