Abstract
Inflammation in the bronchial respiratory tract and lung parenchyma underlies the pathogenesis of chronic obstructive pulmonary disease (COPD). It consists of effector cell infiltration, changes in reticular basement membrane (RBM) thickness, and the content of inflammatory mediators. The aim of this study was to assess the influence of inhaled corticosteroids (ICS) on the number of inflammatory cells and RBM thickness in bronchial biopsies, and pulmonary function in patients with moderate COPD. Twenty four patients with newly diagnosed COPD were included into the study. Pulmonary function tests and fiber optic bronchoscopy with bronchial biopsies were performed before and after 12-month treatment in two groups: ICS– group (LABA plus anticholinergics) and ICS+ group (LABA plus anticholinergics plus ICS). We found that the addition of inhaled corticosteroids to the therapeutic regimen contributed to a reduction of RBM thickness, inflammation, and lung hyperinflation. The intensity of bronchial inflammatory infiltration had little effect on lung function. In conclusion, RBM thickness, an airway wall remodeling element, does not significantly affect the degree of airflow limitation.
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References
Amin K, Ekberg-Jansson A, Lofdahl CG, Venge P (2003) Relationship between inflammatory cells and structural changes in the lungs of asymptomatic and never smokers: a biopsy study. Thorax 58(2):135–142
Barnes P (2004) Mediators of chronic obstructive pulmonary disease. Pharmacol Rev 56:515–548
Bourdin A, Neveu D, Vachier I, Paganin F, Godard P, Chanez P (2007) Specificity of basement membrane thickening severe asthma. J Allergy Clin Immunol 119(6):1367–1374
Burge PS, Calverley PM, Jones PW, Spencer S, Anderson JA, Maslen TK (2000) Randomised, double blind, placebo controlled study of fluticasone propionate inpatients with moderate to severe chronic obstructive pulmonary disease: the ISOLDE trial. BMJ 320(7245):1297–1303
Calverley PM, Anderson JA, Celli B, Ferguson GT, Jenkins CH, Paul W, Jones PW, Yates JC, Veslbo J (2007) Salmeterol and fluticasone propionate and survival in chronic obstructive pulmonary disease. N Engl J Med 356(5):775–789
Celli BR, Helbert RJ, Nordyke RJ, Schau B (2005) Airway obstruction in never smokers: results from the third National Health and nutrition examination survey. Am J Med 118(12):1364–1372
Chanez P, Bourdin A, Vachier I (2004) Effects of inhaled corticosteroids on pathology in asthma and chronic obstructive pulmonary disease. Proc Am Thorac Soc 1(3):184–190
Cosio MG, Ghezzo H, Hogg JC, Corbin R, Loveland M, Dosman J, Macklem PT (1998) The relations between structural changes in small airways and pulmonary-function tests. N Engl J Med 298(23):1277–1281
Culpitt SV, Maziak W, Loukidis S, Nightingale JA, Matthesws JL, Barnes PJ (1999) Effect of high dose inhaled steroid on cells, cytokines, and proteases in induced sputum in chronic obstructive pulmonary disease. Am J Respir Crit Care Med 160(5):1635–1639
Di Stefano A, Capelli A, Lusuardi M, Caramori G, Balbo P, Ioli F, Sacco S, Gnemmi I, Brun P, Adcock IM, Balbi B, Barnes PJ, Chung KF, Donner CF (2001) Decreased T lymphocyte infiltration in bronchial biopsies of subjects with severe chronic obstructive pulmonary disease. Clin Exp Allergy 31(6):893–902
Fabbri LM, Romagnoli M, Corbetta L, Casoni G, Busljetic K, Turato G, Ligabue G, Ciaccia A, Saetta M, Papi A (2003) Differences in airway inflammation in patients with fixed airflow obstruction due to asthma or chronic obstructive pulmonary disease. Am J Respir Crit Care Med 167(3):418–424
GOLD (2014) Global Initiative for Chronic Obstructive Lung Disease: global strategy for the diagnosis, management and prevention of chronic obstructive pulmonary disease. http://www.gold copd.com. Accessed 20 Oct 2017
Górska K, Krenke R, Korczyński P, Domagała-Kulawik J, Nejman-Gryz P, Kosciuch J, Hildebrand K, Chazan R (2008) Eosinophilic airway inflammation in chronic obstructive pulmonary disease and asthma. J Physiol Pharmacol 59(6):261–270
Hattotuwa KL, Gizycki MJ, Ansari TW, Jeffery PK, Barnes NC (2002) The effects of inhaled fluticasone on airway inflammation in chronic obstructive pulmonary disease: a double-blind, placebo-controlled biopsy study. Am J Respir Crit Care Med 165(12):1592–1596
Hogg JC (2004) Pathophysiology of airflow limitation in chronic obstructive pulmonary disease. Lancet 364:709–721
Hurst JR, Veestbo J, Anzueto A, Müllerova H, Tal-Singer R, Miller B, Lomas DA, Agusti A, MacNee W, Calverley P, Rennard S, Wouters EFM, Wedzicha JA (2010) Susceptibility to exacerbation in chronic obstructive pulmonary disease. N Engl J Med 363(12):1128–1138
Jeffery PK (2001) Remodeling in asthma and chronic obstructive lung disease. Am J Respir Crit Care Med 164(10 Pt2):S28–S38
Lams BEA, Sousa AR, Rees PJ, Lee TH (1998) Immunopathology of the small-airway submucosa in smokers with and without chronic obstructive pulmonary disease. Am J Respir Crit Care Med 158(5):1518–1523
Lams BE, Sousa AR, Rees PJ, Lee TH (2000) Subepithelial immunopathology of the large airways in smokers with and without chronic obstructive pulmonary disease. Eur Respir J 15(3):512–516
Lieskier JW, Hacken NH, Zeinstra-Smith M, Rutgers SR, Postma DS, Timens W (2009) Reticular basement membrane in asthma and COPD: similar thickness, yet different composition. Int J Chron Obstruct Pulmon Dis 4:127–135
Lopez AD, Shibuya K, Rao C, Mathers CD, Hansell AL, Held LS, Schmid V, Buist S (2006) Chronic obstructive pulmonary disease: current burden and future projections. Eur Respir J 27(2):397–412
Mathers CD, Loncor D (2006) Projections of global mortality and burden of disease from 2002 to 2030. PLoS Med 3(11):e442
O’Donnell R, Breen D, Wilson S, Djukanowic R (2006) Inflammatory cells in the airways in COPD. Thorax 61(5):448–454
O’Shaughnessy T, Ansari TW, Barnes NC, Jeffery PK (1997) Inflammation in bronchial biopsies of subjects with chronic bronchitis: inverse relationship of CD8+ T lymphocytes with FEV1. Am J Respir Crit Care Med 155(3):852–857
Olloquequi J, Ferrer J, Montes J, Rodríguez E, Montero MA, García-Valero J (2010) Differential lymphocyte infiltration in small airways and lung parenchyma in COPD patients. Respir Med 104(9):1310–1318
Petrescu F, Biciuşcă V, Octavia IP, Forţofoiu CM (2013) Cellular basis of bronchial inflammation in chronic obstructive pulmonary disease. J Cur Health Sci 39(2):61–67
Saetta M, Baraldo S, Corbino L, Turato G, Braccioni F, Rea F, Cavallesco G, Tropeano G, Mapp CE, Maestrelli P, Ciaccia A (1999) CD8+ cells in the lungs of smokers with chronic obstructive pulmonary disease. Am J Respir Crit Care Med 160(2):711–717
Sohal SS, Reid D, Soltani A, Ward C, Weston S, Muller HK, Wood-Baker R, Walters EH (2010) Reticular basement membrane fragmentation and potential epithelial mesenchymal transition is exaggerated in the airways of smokers with chronic obstructive pulmonary disease. Respirology 15(6):930–938
Sohal SS, Reid D, Soltani A, Ward C, Weston S, Muller HK, Wood-Baker R, Walters EH (2011) Evaluation of epithelial mesenchymal transition in patients with chronic obstructive pulmonary disease. Respir Res 12(1):130–137
Sohal SS, Soltani A, Reid D, Ward C, Wills K, Muller HK, Walters EH (2014) A randomized controlled trial of inhaled corticosteroids (ICS) on markers of epithelial – mesenchymal transition (EMT) in large airways samples in COPD: an exploratory proof on concept study. Int J Chron Obstruct Pulmon Dis 9:533–542
Soltani A, Reid DW, Sohal SS, Wood-Baker R, Weston S, Muller HK, Walters EH (2010) Basement membrane and vascular remodeling in smokers and chronic obstructive pulmonary disease: a cross-sectional study. Respir Res 11(1):105
Soltani A, Wood-Baker R, Sukhwinder S, Sohal H, Muller K, Reid D, Walters EH (2012) Reticular basement membrane vessels are increased in COPD bronchial mucosa by both factor VIII and collagen IV immunostaining and are hyperpermeable. J Allergy (Cairo) 2012:958383
Stanescu D, Senna A, Veriter C, Kostianev S, Calcagni PG, Fabbri LM, Maestrelli P (1996) Airways obstruction, chronic expectoration and rapid decline of FEV1 in smokers are associated with increased levels of sputum neutrophils. Thorax 51(3):267–271
Turato G, Di Stefano A, Maestrelli P, Mapp CE, Ruggieri MP, Rogerri A, Fabbri LM, Saetta M (1995) Effect of smoking cessation on airway inflammation in chronic bronchitis. Am J Respir Crit Care Med 152(4):1262–1267
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Toczyska, I., Zwolińska, E., Chcialowski, A. (2017). Influence of Inhaled Corticosteroids on Bronchial Inflammation and Pulmonary Function in Chronic Obstructive Pulmonary Disease with Moderate Obstruction. In: Pokorski, M. (eds) Clinical Investigation. Advances in Experimental Medicine and Biology(), vol 1047. Springer, Cham. https://doi.org/10.1007/5584_2017_129
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DOI: https://doi.org/10.1007/5584_2017_129
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