Effect of an inhaled glucocorticoid on reactive oxygen species production by bronchoalveolar lavage cells from smoking COPD patients

OXIDATIVE stress in the lung is important in the pathogenesis of COPD, Publ ished data indicate that glucocorticoids inhibit blood cells in their capac ity to produce reactive oxygen species (ROS). We investigated the effect of Fluticasone propionate (FP) on the ROS production capabilities of pulmonar y cells. Bronchoalveolar lavage (BAL) was performed in smoking COPD patient s, before and after a six month, placebo-controlled treatment with FP. BAL cells were stimulated with phorbol myristrate acetate (PMA) alone, and toge ther with superoxide dismutase (SOD). From kinetic plots of ferricytochrome -e conversion we calculated the maximal rate of superoxide production: V-ma x. We also examined BAL cell subsets and performed correlation analyses on ROS production and relevant clinical determinants. Paired results were obta ined from 6 FP- and 9 placebo-treated patients. No significant change of V- max was found In both patient groups. Also BAL cellularity was unchanged. C orrelation analyses showed a significant (inverse) association of V-max wit h the number of cigarettes smoked per day. We concluded that a potent inhal ed glucocorticoid had no effect on the ROS production capability of BAL cel ls from smoking COPD patients. Apparently, heavy smoking impaired the abili ty of alveolar macrophages to produce ROS, which was not further decreased by FP.