title: Compare the efficacy of inhaled budesonide and systemic methylprednisolone on systemic inflammation of AECOPD.
abstract: BACKGROUND
  Corticosteroids have been shown to improve the outcome of acute exacerbation of chronic obstructive pulmonary disease (AECOPD). However, whether inhaled corticosteroids (IC) alone have similar effects with systemic corticosteroid (SCS) is still unclear.
  
  
  OBJECTIVE
  To compare the efficacy of inhaled budesonide and systemic methylprednisolone on systemic inflammation of AECOPD.
  
  
  METHODS
  30 AECOPD patients were randomly divided into two group. Budesonide group (15 cases) were treated with inhaled budesonide (3 mg Bid); methylprednisolone group (15 cases) were treated with systemic methylprednisolone (methylprednisolone acetate injectable suspension 40 mg Qd for three days and then methylprednisolone tablets 8 mg Bid). Observe symptoms, lung function, blood gas analysis and adverse effects of the patients in two groups. Peripheral blood samples were collected before and after treatment for 1 day, 4 days and 7 days. Interleukin-8 (IL-8) and TNF-α levels were determined by an enzyme linked immunosorbent assay (ELISA). Hs-CRP levels were detected by automatic biochemical analyzer. Western blotting was used to determine histone deacetylase 2 (HDAC2) protein expression.
  
  
  RESULTS
  Symptoms, pulmonary function and blood gas analysis were significantly improved after treatment in the two groups (P < 0.05) and no significant differences between the two groups (P > 0.05). There were no significant differences of IL-8, TNF-α and hs-CRP levels in the two groups (P > 0.05). Besides, the levels of HDAC2 protein expression before treatment were significantly lower comparing to that after treatment for 4 and 7 days. Incidence of adverse events (heart rate, blood pressure, glycemic, sleep condition, gastrointestinal symptoms) in budesonide group was lower than methylprednisolone group (P < 0.05).
  
  
  CONCLUSIONS
  Inhaled budesonide and systemic methylprednisolone have the same effects on systemic inflammation of AECOPD. Inhaled corticosteroid alone could instead systemic corticosteroid in AECOPD treatment.
authors.affiliation: Department of Respiratory Medicine, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi 530021, China; Department of Respiratory Medicine, Liuzhou People's Hospital, Liuzhou, Guangxi 545006, China.
authors.forename: Xuejiao
authors.initials: X
authors.lastname: Sun
authors.affiliation: Department of Respiratory Medicine, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi 530021, China. Electronic address: zhiyi-river@163.com.
authors.forename: Zhiyi
authors.initials: Z
authors.lastname: He
authors.affiliation: Department of Respiratory Medicine, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi 530021, China.
authors.forename: Jianquan
authors.initials: J
authors.lastname: Zhang
authors.affiliation: Department of Respiratory Medicine, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi 530021, China.
authors.forename: Jingmin
authors.initials: J
authors.lastname: Deng
authors.affiliation: Department of Respiratory Medicine, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi 530021, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Bai
authors.affiliation: Department of Respiratory Medicine, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi 530021, China.
authors.forename: Meihua
authors.initials: M
authors.lastname: Li
authors.affiliation: Department of Respiratory Medicine, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi 530021, China.
authors.forename: Xiaoning
authors.initials: X
authors.lastname: Zhong
mesh_terms: D000368:Aged; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D001784:Blood Gas Analysis; D019819:Budesonide / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D002097:C-Reactive Protein / Q000378:metabolism; D004333:Drug Administration Routes; D004359:Drug Therapy, Combination; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D007249:Inflammation / Q000188:drug therapy* / Q000276:immunology; D016209:Interleukin-8 / Q000378:metabolism; D008297:Male; D008775:Methylprednisolone / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D008875:Middle Aged; D029424:Pulmonary Disease, Chronic Obstructive / Q000188:drug therapy* / Q000276:immunology; D012129:Respiratory Function Tests; D012720:Severity of Illness Index; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism
chemical_list: D000893:Anti-Inflammatory Agents; D016209:Interleukin-8; D014409:Tumor Necrosis Factor-alpha; D019819:Budesonide; D002097:C-Reactive Protein; D008775:Methylprednisolone
keywords: Chronic obstructive pulmonary disease; Exacerbation; Inhaled corticosteroid; Safety