Article Text

other Versions

PDF

Effect of salmeterol/fluticasone propionate on airway inflammation in COPD:a randomized controlled trial
  1. Jean Bourbeau (jean.bourbeau{at}mcgill.ca)
  1. Montreal Chest Institute, Canada
    1. Pota Christodoulopoulos (panagiota.christodoulopoulos{at}mail.mcgill.ca)
    1. McGill University, Canada
      1. Francois Maltais (francois.maltais{at}med.ulaval.ca)
      1. Hôpital Laval, Canada
        1. Yasuhiro Yamauchi
        1. Meakins-Christie Laboratories, Canada
          1. Ronald Olivenstein (ronald.olivenstein{at}mcgill.ca)
          1. Montreal Chest Institute, Canada
            1. Qutayba Hamid (qutayba.hamid{at}mcgill.ca)
            1. Meakins-Christie Laboratories, Canada

              Abstract

              Airway inflammation in chronic obstructive pulmonary disease (COPD) is characterized by infiltration of CD8+ T cells and CD68+ macrophages and an increased number of neutrophils, whereas few studies have described the presence of eosinophils. Although anti-inflammatory effects of corticosteroids in stable COPD are unclear, recent studies suggest that combination therapy could be beneficial. We therefore evaluated combined salmeterol/fluticasone propionate (SFC) and fluticasone propionate (FP) alone on inflammatory cells in the airways of COPD patients. Patients were treated in a randomized, double-blind, parallel-group, placebo-controlled trial with either a combination of 50μg salmeterol and 500μg FP twice daily ([SFC] n=19, 19 male, mean age 62), 500μg FP twice daily (n=20, 15 male, mean age 64), or placebo (n=21, 17 male, mean age 66) for 3 months. At the start and end of treatment, bronchoscopy with bronchial biopsies was performed, and numbers of CD8+ T lymphocytes, CD68+ macrophages, neutrophils and eosinophils were measured. CD8+ cells were significantly reduced by SFC compared with placebo (difference -98.05 cells/mm2; 95% CI -143.14 to -52.9; p<0.001). Such a marked effect was not seen with FP alone (-44.67 cells/mm2; 95% CI -90.92 to 1.57; p=0.06). CD68+ macrophages were also reduced by SFC compared with placebo (difference -31.68 cells/mm2; 95% CI -61.07 to -2.29; p=0.03) but not by FP. SFC did not significantly change neutrophils and eosinophils compared with placebo. SFC has airway anti-inflammatory effects not seen with inhaled corticosteroids alone.

              • Chronic obstructive pulmonary disease
              • airway inflammation
              • bronchoscopy
              • combination therapy
              • fluticasone propionate

              Statistics from Altmetric.com

              Request permissions

              If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

              Linked Articles

              • Airwaves
                Wisia Wedzicha
              • Editorial
                BMJ Publishing Group Ltd and British Thoracic Society