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Clinical Investigations: COPD |

Inhaled Corticosteroids in Stable COPD Patients*: Do They Have Effects on Cells and Molecular Mediators of Airway Inflammation?

Bruno Balbi, MD, PhD; Maria Majori, MD; Stefano Bertacco, MD; Giuseppe Convertino, MD; Angelo Cuomo, MD; Claudio F. Donner, MD, FCCP; Alberto Pesci, MD, FCCP
Author and Funding Information

*From the Salvatore Maugeri Foundation (Drs. Balbi, Convertino, and Donner), Scientific Institute for Care and Research, Rehabilitation Institute of Veruno, Section of Varallo Sesia, Italy; and the Department of Respiratory Diseases (Drs. Majori, Bertacco, Cuomo, and Pesci), University of Parma, Italy.

Correspondence to: Bruno Balbi, MD, PhD, Salvatore Maugeri Foundation, Rehabilitation Institute of Veruno, Section of Varallo Sesia, Via Gippa 3, 13019 Varallo Sesia (Vc), Italy;



Chest. 2000;117(6):1633-1637. doi:10.1378/chest.117.6.1633
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Study objective: To investigate possible changes in cells and molecular mediators of airway inflammation following inhaled steroid treatment of stable COPD patients.

Design: Six-week open preliminary prospective study.

Setting: A university respiratory disease clinic.

Patients: Stable COPD patients with mild disease.

Intervention: Six-week treatment with inhaled beclomethasone (1.5 mg die).

Measurements: The levels of interleukin (IL)-8, myeloperoxidase, eosinophilic cationic protein and tryptase, and cell numbers in bronchial lavage specimens were determined, and the symptom score, the endoscopic bronchitis index, and functional parameters were recorded.

Results: After treatment there were significant reductions in the lavage levels of IL-8 ([mean± SEM] 1,603.4 ± 331.2 vs 1,119.2 ± 265.3 pg/mL, respectively; p = 0.01) and myeloperoxidase (1,614.5 ± 682.3 vs 511.2 ± 144.2 μg/L, respectively; p = 0.05), in cell numbers (250.6 ± 27.7 vs 186.3 ± 11.5 cells × 103/mL, respectively; p = 0.04), neutrophil proportion (59.7 ± 14.3% vs 31.5 ± 10.1%; p = 0.01), symptom score (4.5 ± 0.6 vs 1.4 ± 0.5; p = 0.01), and bronchitis index (8.5 ± 0.8 vs 5.5 ± 0.7; p = 0.007).

Conclusions: In stable patients with COPD, inhaled steroid treatment may induce changes on some cellular and molecular parameters of airway inflammation.

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