title: Effect of fluticasone propionate on sputum of patients with chronic bronchitis and emphysema.
abstract: The effects of fluticasone propionate (FP) on sputum chemotactic activity, elastase inhibitory potential, albumin concentrations, and peripheral neutrophil function were studied in a group of patients with clinically stable, smoking-related chronic bronchitis and emphysema. Seventeen patients (50 to 75 yr of age) were entered into a double-blind, placebo-controlled study of 1.5 mg inhaled FP/d for 8 wk. Following treatment with FP the chemotactic activity of the sputum sol phase was lower than the corresponding values for the placebo group (p < 0.01). Values fell from a mean of 21.75 (+/- 1.58) during the run-in period to 18.37 (+/- 1.46; p < 0.01) after 4 wk and 17.63 (+/- 1.86; p < 0.05) after 8 wk treatment returning to 22.08 (+/- 1.26) cell/field after the washout period. The neutrophil elastase inhibitory capacity of the sputum sol phase increased (p < 0.025) with treatment from a mean of 0.177 microM elastase inhibited/L (+/- 0.05) pretreatment to 0.413 microM (+/- 0.054) after 4 wk and 0.415 microM (+/- 0.054) after 8 wk returning to 0.270 microM (+/- 0.07) after the washout period. Treatment with FP did not result in a change in the peripheral neutrophil functions studied or sputum albumin and myeloperoxidase concentrations. The results suggest that FP may play a protective role in these patients through a reduction in the chemotactic activity of lung secretions and potentially a reduction in the recruitment of neutrophils to the lung, and also by directly affecting the proteinase/antiproteinase balance, in favor of antiproteinases, within lung secretions.
authors.affiliation: Lung Immunobiochemical Research Laboratory, General Hospital, Birmingham, United Kingdom.
authors.forename: C G
authors.initials: CG
authors.lastname: Llewellyn-Jones
authors.forename: T A
authors.initials: TA
authors.lastname: Harris
authors.forename: R A
authors.initials: RA
authors.lastname: Stockley
mesh_terms: D000280:Administration, Inhalation; D000368:Aged; D000418:Albumins / Q000032:analysis; D000730:Androstadienes / Q000008:administration & dosage / Q000494:pharmacology*; D001991:Bronchitis / Q000188:drug therapy / Q000503:physiopathology*; D002634:Chemotaxis, Leukocyte / Q000187:drug effects; D002908:Chronic Disease; D004311:Double-Blind Method; D005260:Female; D005353:Fibronectins / Q000378:metabolism; D000068298:Fluticasone; D005938:Glucocorticoids / Q000008:administration & dosage / Q000494:pharmacology*; D006801:Humans; D019272:Leukocyte Elastase; D008297:Male; D008875:Middle Aged; D009504:Neutrophils / Q000187:drug effects / Q000378:metabolism / Q000502:physiology; D010196:Pancreatic Elastase / Q000032:analysis; D009195:Peroxidase / Q000032:analysis; D011656:Pulmonary Emphysema / Q000188:drug therapy / Q000503:physiopathology*; D013183:Sputum / Q000737:chemistry / Q000166:cytology / Q000187:drug effects*; D013481:Superoxides / Q000378:metabolism
chemical_list: D000418:Albumins; D000730:Androstadienes; D005353:Fibronectins; D005938:Glucocorticoids; D013481:Superoxides; D000068298:Fluticasone; D009195:Peroxidase; D010196:Pancreatic Elastase; D019272:Leukocyte Elastase