Effect of an inhaled glucocorticoid on endothelial function in healthy smokers.
Cigarette smoking is associated with attenuated endothelium-dependent vasodilation (endothelial dysfunction) in the systemic circulation, including the airway circulation. We wished to determine whether an inhaled corticosteroid could restore endothelial function in the airway of lung-healthy current smokers, ex-smokers, and nonsmokers. We measured baseline airway blood flow (Qaw) and Qaw reactivity to inhaled albuterol as an index of endothelium-dependent vasodilation and to sublingual nitroglycerin as an index of endothelium-independent vasodilation in lung-healthy current smokers, ex-smokers, and nonsmokers. Current smokers were then treated with inhaled fluticasone for 3 wk, and all measurements were repeated after fluticasone treatment and after a subsequent 3-wk fluticasone washout period. Baseline mean Qaw and endothelium-independent Qaw reactivity were similar in the three groups. Mean endothelium-dependent Qaw reactivity was 49.5% in nonsmokers, 42.7% in ex-smokers, and 10.8% in current smokers (P < 0.05 vs. nonsmokers). In current smokers, mean baseline Qaw was unchanged after fluticasone treatment, but endothelium-dependent Qaw reactivity significantly increased to 34.9%. Qaw reactivity was again blunted after fluticasone washout. Endothelial dysfunction, as assessed by vascular reactivity, can be corrected with an inhaled corticosteroid in the airway of lung-healthy current smokers. This proof of concept can serve as the basis for future clinical investigations on the effect of glucocorticoids on endothelial function in smokers.
Mendes
Eliana S
ES
Division of Pulmonary and Critical Care Medicine, Department of Medicine, Miller School of Medicine, University of Miami, Miami, FL 33136, USA. emendes@med.miami.edu
Horvath
Gabor
G
Rebolledo
Patricia
P
Monzon
Maria Elena
ME
Casalino-Matsuda
S Marina
SM
Wanner
Adam
A
D000280:Administration, Inhalation; D000293:Adolescent; D000328:Adult; D000420:Albuterol / Q000008:administration & dosage / Q000494:pharmacology; D000730:Androstadienes / Q000008:administration & dosage / Q000494:pharmacology*; D001993:Bronchodilator Agents / Q000008:administration & dosage / Q000494:pharmacology*; D004727:Endothelium / Q000187:drug effects*; D005260:Female; D000068298:Fluticasone; D005541:Forced Expiratory Volume / Q000187:drug effects / Q000502:physiology; D005938:Glucocorticoids / Q000008:administration & dosage / Q000494:pharmacology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009126:Muscle Relaxation / Q000187:drug effects; D009131:Muscle, Smooth, Vascular / Q000187:drug effects; D005996:Nitroglycerin / Q000494:pharmacology; D012039:Regional Blood Flow / Q000187:drug effects; D012129:Respiratory Function Tests; D012137:Respiratory System / Q000098:blood supply; D012907:Smoking / Q000503:physiopathology*; D013147:Spirometry; D014665:Vasodilator Agents / Q000494:pharmacology
D000730:Androstadienes; D001993:Bronchodilator Agents; D005938:Glucocorticoids; D014665:Vasodilator Agents; D000068298:Fluticasone; D005996:Nitroglycerin; D000420:Albuterol