Library Open Repository

Bronchodilator reversibility, airway eosinophilia and anti-inflammatory effects of inhaled fluticasone in COPD are not related

Downloads

Downloads per month over past year

Reid, DW and Wen, Y and Johns, DP and Williams, TJ and Ward, C and Walters, EH (2008) Bronchodilator reversibility, airway eosinophilia and anti-inflammatory effects of inhaled fluticasone in COPD are not related. Respirology, 13 (6). pp. 799-809. ISSN 1323-7799

[img] PDF
Reid_Respirology.pdf | Request a copy
Full text restricted
Available under University of Tasmania Standard License.

Abstract

Background and objective: Bronchodilator reversibility (BDR) is common in smoking-related COPD, but the airway pathology underlying this has not been described. In particular, it is not known whether BDR is associated with underlying airway eosinophilia and whether BDR is predictive of a better response to inhaled corticosteroid (ICS) treatment. Methods: A double-blind, placebo-controlled, randomized 2 : 1 study of fluticasone propionate (FP), 500 µg twice daily versus placebo over 6 months was performed in subjects with mild to moderate COPD. Subjects with a clinical history of asthma were excluded, but not on BDR criteria alone. Induced sputum, BAL and endobronchial biopsies (EBB) were performed in 36 subjects at baseline, and 30 of these provided a second full set of samples (FP, n = 19; placebo, n = 11). Results: Baseline BDR was not related to airway eosinophilia and did not predict response to ICS. Post-bronchodilator FEV1 increased in the FP group compared with the placebo group (P = 0.05), and there were within-treatment group reductions in total symptom scores with FP (P < 0.05). Compared with placebo, FP reduced macrophage numbers but increased neutrophil numbers in EBB (P = 0.01 and P = 0.003, respectively). BAL neutrophil and epithelial cell numbers were also reduced with FP (P = 0.03 for both). There were within-treatment group reductions in the numbers of EBB mast cells and CD8+ve lymphocytes with FP (P = 0.007). Conclusions: BDR was not related to any particular inflammatory phenotype or any clinical or anti-inflammatory response to ICS in these subjects with mild to moderate COPD.

Item Type: Article
Keywords: airways • bronchodilatation • COPD • inflammation • steroid
Journal or Publication Title: Respirology
Page Range: pp. 799-809
ISSN: 1323-7799
Identification Number - DOI: 10.1111/j.1440-1843.2008.01380.x
Additional Information: The definitive published version is available online at: http://interscience.wiley.com
Date Deposited: 20 Jan 2009 00:54
Last Modified: 18 Nov 2014 03:55
URI: http://eprints.utas.edu.au/id/eprint/8236
Item Statistics: View statistics for this item

Repository Staff Only (login required)

Item Control Page Item Control Page