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 med iators 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, eosinophil ic cationic protein and tryptase, and cell numbers in bronchial lavage spec imens were determined, and the symptom score, the endoscopic bronchitis ind ex, and functional parameters were recorded. Results: After treatment there were significant reductions in the lavage le vels 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 mu g/L, respectively; p = 0.05), in cell numbers (250.6 +/- 27.7 vs 186.3 +/- 11.5 cells x 10(3)/mL, respectively; p = 0.04), neutrophil propor tion (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 in duce changes on some cellular and molecular parameters of airway inflammati on.