Airway inflammation in asthma and chronic obstructive pulmonary disease with special emphasis on the antigen-presenting dendritic cell: influence of treatment with fluticasone propionate

Asthma is a chronic inflammatory disorder of the airways characterized by v ariable airflow limitation and airway hyperresponsiveness. The type of infl ammatory response in asthma is compatible obstructive pulmonary disease (CO PD) are also markedly inflamed; however, the predominant types of inflammat ory cells and the main anatomical site of the lesion appear to differ from those in asthma. COPD is characterized by reduced maximum expiratory Row an d slow forced emptying of the lungs. Steroids are the most prominent medica tion used in the treatment of asthma and COPD; however, the beneficial effe ct of steroid treatment in COPD is subject of debate. We investigated the e fficacy of fluticasone propionate (FP treatment in atopic asthmatics and in COPD patients with bronchial hyperreactivity who smoke. The effect of the treatment on bronchial hyperreactivity and indices of the methacholine dose -response curve were analysed, as well as indices of inflammation of the ai rway mucosa with special emphasis on the antigen presenting dendritic cell. Treatment of allergic asthmatic patients resulted in improvement of lung f unction (FEV1), a decrease in bronchial hyperresponsiveness and a decrease of maximal airway narrowing. During the FP-treatment of COPD patients, FEV1 remained stable, while FEV1 deteriorated significantly in the placebo grou p. Therefore, steroid treatment may have a beneficial effect in COPD patien ts with bronchial hyperresponsiveness (BHR). Since immunohistochemical anal ysis of bronchial biopsy specimens from asthma and COPD patients show disea se-specific aspects of inflammation, the anti-inflammatory effect of EP is obtained through modulation of different cell populations in asthma and COP D.