INHIBITORY EFFECTS OF INHALED FLUNISOLIDE ON INFLAMMATORY FUNCTIONS OF ALVEOLAR MACROPHAGES

We have studied 15 patients with slight or moderate bronchial obstruct ion, all of whom were being treated by inhalation of the beta-mimetic fenoterol 4 x 400 mug/day, and 7 of whom were also receiving inhaled f lunisolide 2 x 500 mug/day. The therapy had been given for longer than 1 month in each case. Bronchoscopy and bronchoalveolar lavage (BAL) w as done for diagnosis or follow up of bronchial diseases. None of the patients showed signs of any interstitial lung disease. Conditioned cu lture supernatants were produced by cultivating alveolar macrophages ( AM) for 24 h using standard conditions. To detect all the biological e ffects both of IL-1alpha and IL-1 beta in the culture supernatants a m odification of the standard mouse IL-1 thymocyte bioassay was used. Th e TNF concentration in culture supernatants was measured by ELISA. Fre e oxygen radical release by alveolar macrophages was determined by the detection of chemiluminescence. Both IL-1 and TNF production were sig nificantly lower in patients receiving fenoterol plus flunisolide than in patients on fenoterol alone. In contrast, no difference could be o bserved in the release of free oxygen radicals from alveolar macrophag es. Thus, for the first time an ex vivo study has revealed an interrel ation between inhaled glucocorticoid therapy and inhibition of importa nt mediators of inflammatory processes in the lower respiratory tract.