NEDOCROMIL SODIUM IN OBSTRUCTIVE AIRWAYS DISEASE - EFFECT ON SYMPTOMSAND PLASMA-PROTEIN LEAKAGE IN SPUTUM

In patients with asthma or chronic obstructive pulmonary disease, ther e is chronic airway inflammation with increased leakage of plasma prot eins into the airway lumen, which can be reduced by inhaled glucocorti costeroids. Nedocromil sodium is an anti-inflammatory drug, and we que stioned whether it also affects the leakage of plasma proteins. In a d ouble-blind placebo-controlled study we investigated the effect of 12 weeks of treatment with nedocromil on forced expiratory volume in one second (FEV1), provocative concentration of histamine causing a 20% fa ll in FEV1 (PC20), peak flow, symptom scores, and plasma protein leaka ge in sputum, in 31 patients with obstructive airways disease and sput um production (mean (range) FEV1 61% of predicted (42-87%); geometric mean (range) PC20 0.39 (0.04-2.9) mg.mL(-1)). As a measure for plasma protein leakage we calculated the relative coefficients of excretion ( RCE) of proteins from serum to the soluble phase of sputum. There was a small increase in morning and evening peak flow (p<0.05) and a decre ase in night-time bronchodilator use (p<0.02) in favour of nedocromil, The RCE of alpha(2)-macroglobulin to albumin significantly decreased after treatment with nedocromil (p=0.03). The results show limited cli nical efficacy of nedocromil in our study group, They further suggest that the anti-inflammatory properties of nedocromil extend to inhibiti on of plasma protein leakage into the airways.