The effect of tiotropium therapy on markers of elastin degradation in COPD.
BACKGROUND
Desmosine and Isodesmosine (D/I) are cross-linking amino acids which are present only in mature elastin. Changes in their concentration in body fluids indicate changes in elastin degradation and can be a reflection of tissue elastase activity. This study was undertaken to determine whether continuous therapy with the long-acting bronchodilator Tiotropium bromide (TTP) could result in reductions in D/I as measured by mass spectrometry in plasma, urine and sputum.


METHODS
Twelve not currently smoking patients with chronic obstructive pulmonary disease (COPD), never on TTP, were selected for study. Levels of D/I, along with measurements of FVC, FEV1 and FEV1/FVC. were determined before starting TTP daily, and then one and two months after.


RESULTS
D/I decreased in plasma (10 of 12 patients), in sputum all (12 of 12), and in the percentage of free D/I in urine (10 of 12). Most patients showed slight increases in FVC and FEV1 percent predicted over two months.


CONCLUSIONS
The results are consistent with an effect of prolonged bronchodilitation by anti-cholinergic blockade to also result in reduced lung elastin degradation.
Ma
Shuren
S
James P. Mara Center for Lung Disease, St. Luke's-Roosevelt Hospital Center, 1000 Tenth Avenue, New York, NY 10019, USA. sm2202@columbia.edu
Lin
Yong Y
YY
Tartell
Lori
L
Turino
Gerard M
GM
D001993:Bronchodilator Agents / Q000627:therapeutic use*; D003895:Desmosine / Q000097:blood / Q000378:metabolism / Q000652:urine; D004549:Elastin / Q000378:metabolism*; D005541:Forced Expiratory Volume; D006801:Humans; D007524:Isodesmosine / Q000097:blood / Q000378:metabolism / Q000652:urine; D010196:Pancreatic Elastase / Q000187:drug effects / Q000378:metabolism; D029424:Pulmonary Disease, Chronic Obstructive / Q000188:drug therapy* / Q000503:physiopathology; D012602:Scopolamine Derivatives / Q000627:therapeutic use*; D016540:Smoking Cessation; D000069447:Tiotropium Bromide; D014797:Vital Capacity
D001993:Bronchodilator Agents; D012602:Scopolamine Derivatives; D003895:Desmosine; D004549:Elastin; D007524:Isodesmosine; D010196:Pancreatic Elastase; D000069447:Tiotropium Bromide