Changes in inflammatory markers following treatment of acute exacerbationsof obstructive pulmonary disease

The aim of the study was to investigate changes in inflammatory markers fol lowing emergency treatment of obstructive pulmonary disease. The study comp rised 43 patients. After acute treatment, they were given either 30 mg of p rednisolone p.o. or 1600 mug of inhaled budesonide daily for 1 week. Over t he following 3 weeks, all the patients were given 1600 mug of inhaled budes onide daily. Blood samples for measurements of eosinophil cationic protein (S-ECP), eosinophil peroxidase (S-EPO), total eosinophil count (B-Eos), mye loperoxidase (S-MPO) and human neutrophil lipocaline (HNL) were taken and s pirometry was performed before emergency treatment and after 1 and 4 weeks. There was no difference in the improvement in forced expiratory volume in 1 sec (FEV1) between patients given prednisolone or budesonide. Patients wi th an improvement in FEV1 of greater than or equal to 20% of baseline after 1 and 4 weeks displayed a larger decrease in eosinophil markers. The corre lation between Delta FEV1 and DeltaS-ECP was r= -0.37, P<0.05, <Delta>S-EPO -0.40, P<0.01 and <Delta>B-Eos -0.44, P<0.01, after 4 weeks. This correlati on was highly significant in patients who had smoked <less than or equal to >5 pack-years, while the correlation was not significant in patients with a longer smoking history and chronic airflow limitation (best FEV1 <80% of p redicted). We conclude that the change in eosinophil markers is correlated to the improvement in lung function in non-smokers or short-term smokers fo llowing the emergency treatment of obstructive pulmonary disease. This stud y indicates that following eosinophil markers is more useful in patients wi th asthma than patients with COPD. (C) 2001 Harcourt Publishers Ltd.