title: Effects of inhaled corticosteroids on pathology in asthma and chronic obstructive pulmonary disease.
abstract: The effects of inhaled corticosteroids (ICSs) have been investigated in asthma and chronic obstructive pulmonary disease (COPD) using endobronchial biopsies. In asthma, most studies have shown reductions in infiltrating eosinophils, mast cells, and T lymphocytes. Cell-associated mediators, such as cytokines derived from type 2 T-helper lymphocytes, are decreased as assessed by immunostaining and molecular biology techniques. More recently, attention has been devoted to the effect of ICSs on structural changes. In asthma, ICSs have been shown in some studies to affect collagen deposition (size of the reticular basement membrane), the number of vessels, or epithelial integrity. The correlations between those findings and various clinical and functional outcomes are far from clear. A long-term study has shown a decrease in the basement membrane size in a group of patients with asthma treated according to their level of airway hyperreactivity. In COPD, ICSs generally do not decrease neutrophils, macrophages, and CD8(+) T lymphocytes. The effects of these drugs on structural changes in COPD have not been investigated extensively. Long-term prospective studies are needed to demonstrate the potential for ICSs to affect the natural history of chronic bronchial diseases.
authors.affiliation: Clinique des Maladies Respiratoires, Hôpital Arnaud de Villeneuve, 371 Avenue du Doyen Gaston Giraud, 34295 Montpellier Cedex 5, France. chanez@montp.inserm.fr
authors.forename: Pascal
authors.initials: P
authors.lastname: Chanez
authors.forename: Arnaud
authors.initials: A
authors.lastname: Bourdin
authors.forename: Isabelle
authors.initials: I
authors.lastname: Vachier
authors.forename: Philippe
authors.initials: P
authors.lastname: Godard
authors.forename: Jean
authors.initials: J
authors.lastname: Bousquet
authors.forename: A M
authors.initials: AM
authors.lastname: Vignola
mesh_terms: D000280:Administration, Inhalation; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage*; D000403:Airway Resistance / Q000187:drug effects; D001249:Asthma / Q000188:drug therapy* / Q000473:pathology*; D001707:Biopsy, Needle; D001999:Bronchoscopy; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D011379:Prognosis; D029424:Pulmonary Disease, Chronic Obstructive / Q000188:drug therapy* / Q000473:pathology*; D018570:Risk Assessment; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D000305:Adrenal Cortex Hormones