Formoterol attenuates neutrophilic airway inflammation in asthma.
OBJECTIVE
Airway neutrophil levels are increased in patients with severe asthma and during asthma exacerbations. Long-acting beta2-agonists (LABAs), such as formoterol, reduce the number of asthma exacerbations. While beta2-agonists may affect neutrophil function in vitro, it is uncertain whether they have effects on neutrophilic inflammation in asthmatic patients in vivo.


METHODS
In a double-blind randomized crossover study, we evaluated the effects of 4 weeks of treatment with formoterol (Turbuhaler), 24 microg bid, compared to placebo on sputum neutrophil numbers and interleukin (IL)-8 levels in asthmatic patients. Therapy with budesonide (administered via Turbuhaler), 400 microg bid for 4 weeks, was added at the end as a "gold standard" antiinflammatory effect comparison.


METHODS
We studied 15 steroid-naïve nonsmoking patients who ranged from 19 to 51 years of age and had mild persistent asthma.


RESULTS
Formoterol therapy significantly reduced sputum IL-8 levels and neutrophil numbers compared to placebo. There was a significant correlation between the reduction in sputum IL-8 levels and the number of neutrophils, indicating that formoterol may attenuate neutrophilic airway inflammation by inhibiting IL-8 production.


CONCLUSIONS
Our data suggest that the LABA formoterol reduces neutrophilic airway inflammation in patients with mild asthma and that this might be beneficial in preventing asthma exacerbations.
Maneechotesuwan
Kittipong
K
Department of Thoracic Medicine, National Heart and Lung Institute, Imperial College London, UK.
Essilfie-Quaye
Sarah
S
Meah
Sally
S
Kelly
Claire
C
Kharitonov
Sergei A
SA
Adcock
Ian M
IM
Barnes
Peter J
PJ
D000328:Adult; D001249:Asthma / Q000097:blood / Q000188:drug therapy* / Q000503:physiopathology; D001993:Bronchodilator Agents / Q000627:therapeutic use*; D004311:Double-Blind Method; D004983:Ethanolamines / Q000627:therapeutic use*; D005260:Female; D005541:Forced Expiratory Volume; D000068759:Formoterol Fumarate; D006801:Humans; D007249:Inflammation / Q000517:prevention & control*; D008297:Male; D016210:Methacholine Chloride / Q000627:therapeutic use; D008875:Middle Aged; D009504:Neutrophils / Q000502:physiology; D009569:Nitric Oxide / Q000032:analysis; D012129:Respiratory Function Tests; D014797:Vital Capacity
D001993:Bronchodilator Agents; D004983:Ethanolamines; D016210:Methacholine Chloride; D009569:Nitric Oxide; D000068759:Formoterol Fumarate