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

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 6 SEM] 1,603.4 6 331.2 vs 1,119.2 6 265.3 pg/mL, respectively; p 5 0.01) and myeloperoxidase (1,614.5 6 682.3 vs 511.2 6 144.2 mg/L, respectively; p 5 0.05), in cell numbers (250.6 6 27.7 vs 186.3 6 11.5 cells 3 10 3 /mL, respectively; p 5 0.04), neutrophil proportion (59.7 6 14.3% vs 31.5 6 10.1%; p 5 0.01), symptom score (4.5 6 0.6 vs 1.4 6 0.5; p 5 0.01), and bronchitis index (8.5 6 0.8 vs 5.5 6 0.7; p 5 0.007). Conclusions: In stable patients with COPD, inhaled steroid treatment may induce changes on some cellular and molecular parameters of airway inflammation. (CHEST 2000; 117:1633‐1637)