Impact of Inhaled Corticosteroids Treatment on the Amount of BALF and Local Bronchial

Impact of inhaled corticosteroids treatment on the amount of BALF and local bronchial eosinophyles, reticular basement membrane thickness and pulmonary function test in patients with moderate obstructions in COPD.

A. Chcialowski1, I. Toczyska1, W. Lubinski1†, Cezary Jochymski2, W. Stankiewicz3 1Department of Internal Medicine Pneumonology and Allergology, 2Department of Pathology Military Institute of Medicine, 3 Military Institute of Hygiene and Epidemiology Warsaw, Poland

Inflammation in bronchial respiratory tract and lung parenchyma is the main process responsible for the signs and symptoms in patients with chronic obstructive pulmonary disease (COPD). It is described by the composition of effector cells infiltration, changes in reticular basement membrane thickness and concentrations of inflammatory mediators. The aim of the study was to assess the impact of inhaled glucocortycosteroides (ICS) treatment on the number of eosinophyles in bronchoalveolar lavage fluid (BALF), local bronchial wall inflammation, reticular basement membrane (RBM) thickness and pulmonary function tests in patients with moderate COPD. Material and methods. Twenty four patients with newly diagnosed moderate COPD (never treated) were included into the study. Each one had a lung function test performed and fibreoptic bronchoscopy with BALF and bronchial biopsy procedure carried out, before the institution of treatment and 12 months after the inhaler treatment; group (ICS-) n=13 (cholinolitic and LABA), and group (ICS+) n=11 (cholinolytic, LABA and ICS. Results. The twelve- month treatment resulted in a statistically significant (p< 0,05) reduction in RBM thickness, a significant decrease in the percentage of eosinophyiles in BALF and non-significant increase in the number of these cells in local bronchial inflammatory process in both the groups. There were significant alterations in RV%TLC values and airway resistance in ICS+ group. There has been observed a significant correlation between the intensity of local bronchial eosinophilic inflammation and the thickness of RBM (r=0,74) before the treatment only in (ICS+) and between local bronchial eosinophilic inflammation and FEV1 (r=0,72) and RV%TLC (r=0,56) respectively. Summary. Our data indicate that the combined (with ICS) therapy shows a partial influence on bronchial eosinophilic inflammation in BALF and local eosinophilic inflammation with no effect on lung function