title: Addition of inhaled corticosteroid on combined bronchodilator therapy in patients with COPD.
abstract: OBJECTIVE
  Bronchodilator therapy is the first step treatment in patients with COPD. The beneficial effects of corticosteroids either in health status or in airway inflammation in COPD have been previously studied. The aim of this study was to evaluate whether adding inhaled corticosteroids to combined bronchodilator therapy has additive clinical and anti-inflammatory effects in COPD patients.
  
  
  METHODS
  Thirty patients with COPD were included in the study. All patients were receiving inhaled anticholinergic and long-acting beta-2 agonist. Inhaled corticosteroid (budesonide 800 microg daily) was added to their current medications for 12 weeks. Before and after this treatment period, spirometric values and arterial blood gas parameters were determined, blood was drawn for measurement of serum inflammatory markers and sputum was induced.
  
  
  RESULTS
  All patients were male, mean age was 67.7+/-8.7 years and duration of disease was 9.7+/-4.3 years. The induced sputum total cell counts, eosinophil and neutrophil counts decreased with corticosteroid treatment. The induced sputum IL-8 and TNF-alpha levels decreased significantly (IL-8; 835.9+/-217 versus 378.4+/-105 pg/ml, p=0.0001, TNF-alpha; 320.7+/-129 versus 201.3+/-52 pg/ml, p=0.003). Serum inflammatory markers and sputum LTB4 levels did not change with treatment.
  
  
  CONCLUSIONS
  These results suggested that the addition of inhaled corticosteroids to combined bronchodilator therapy might have anti-inflammatory effects in patients with COPD.
authors.affiliation: Chest Disease Department, Faculty of Medicine, Kocaeli University, PK 14 Derince 41900 Kocaeli, Turkey. dr_basyigit@yahoo.com
authors.forename: Ilknur
authors.initials: I
authors.lastname: Basyigit
authors.forename: Fusun
authors.initials: F
authors.lastname: Yildiz
authors.forename: Sevgiye Kacar
authors.initials: SK
authors.lastname: Ozkara
authors.forename: Elif
authors.initials: E
authors.lastname: Yildirim
authors.forename: Hasim
authors.initials: H
authors.lastname: Boyaci
authors.forename: Ahmet
authors.initials: A
authors.lastname: Ilgazli
mesh_terms: D000280:Administration, Inhalation; D000368:Aged; D015415:Biomarkers / Q000032:analysis; D001993:Bronchodilator Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D019819:Budesonide / Q000008:administration & dosage / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D006801:Humans; D007249:Inflammation; D008297:Male; D008875:Middle Aged; D029424:Pulmonary Disease, Chronic Obstructive / Q000188:drug therapy*; D012129:Respiratory Function Tests; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D001993:Bronchodilator Agents; D019819:Budesonide