title: Roflumilast, a phosphodiesterase-4 inhibitor, induces phagocytic activity in Greek COPD patients.
abstract: BACKGROUND
  A new approach to the treatment of COPD includes controlling inflammation because of its important role in exacerbation of the disease. Recently, roflumilast has been added as a therapeutic option for COPD. Roflumilast is an oral phosphodiesterase-4 inhibitor that targets inflammatory cells involved in triggering exacerbations of COPD. The objective of the current study was to evaluate roflumilast for its contribution to phagocytic activity in COPD patients.
  
  
  METHODS
  Twenty-one patients diagnosed with COPD received roflumilast once daily for 6 months in combination with fluticasone (an inhaled corticosteroid), salmeterol (a long-acting β2-agonist), and tiotropium (a long-acting muscarinic antagonist) or combinations of these agents. The main inclusion criterion was stable disease for at least the previous 30 days. Neutrophils and spirometric changes, ie, forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC), were measured in the COPD patients at indicated time points. The first sample was taken before receiving roflumilast, the second 3 months later, and the third after 6 months. Examination of defective phagocytosis was done by flow cytometry using a FagoFlowEx(®) kit. The statistical analysis was performed using Statistica software.
  
  
  RESULTS
  Our results indicate that phagocytic activity was increased after 3 and 6 months of treatment when compared with baseline (P<0.001). Similarly, FVC and FEV1 were also increased during the 6-month period, but only FVC differed significantly from baseline (P<0.001).
  
  
  CONCLUSIONS
  Although the number of patients in this study was limited, our results indicate that roflumilast induces phagocytic activity, which improves lung function.
authors.affiliation: Pulmonary Department-Oncology Unit, G Papanikolaou General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Porpodis
authors.affiliation: Pulmonary Department-Oncology Unit, G Papanikolaou General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
authors.forename: Kalliopi
authors.initials: K
authors.lastname: Domvri
authors.affiliation: Pulmonary Department-Oncology Unit, G Papanikolaou General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
authors.forename: Paul
authors.initials: P
authors.lastname: Zarogoulidis
authors.affiliation: Department of Food Technology, School of Food Technology and Nutrition, Alexander Technological Educational Institute, Aristotle University of Thessaloniki, Thessaloniki, Greece.
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Petridis
authors.affiliation: Pulmonary Department-Oncology Unit, G Papanikolaou General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
authors.forename: Katerina
authors.initials: K
authors.lastname: Tsirgogianni
authors.affiliation: Pulmonary Department-Oncology Unit, G Papanikolaou General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
authors.forename: Antonis
authors.initials: A
authors.lastname: Papaioannou
authors.affiliation: Pulmonary Department, Immunology and Histocompatibility Laboratory, G Papanikolaou General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
authors.forename: Olga
authors.initials: O
authors.lastname: Hatzizisi
authors.affiliation: Pulmonary Department-Oncology Unit, G Papanikolaou General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
authors.forename: Ioannis
authors.initials: I
authors.lastname: Kioumis
authors.affiliation: Pulmonary Department, Immunology and Histocompatibility Laboratory, G Papanikolaou General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Liaka
authors.affiliation: Pulmonary Department, Immunology and Histocompatibility Laboratory, G Papanikolaou General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
authors.forename: Violeta
authors.initials: V
authors.lastname: Kikidaki
authors.affiliation: Pulmonary Department-Oncology Unit, G Papanikolaou General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
authors.forename: Sofia
authors.initials: S
authors.lastname: Lampaki
authors.affiliation: Pulmonary Department-Oncology Unit, G Papanikolaou General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
authors.forename: John
authors.initials: J
authors.lastname: Organtzis
authors.affiliation: Pulmonary Department-Oncology Unit, G Papanikolaou General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Zarogoulidis
mesh_terms: D000280:Administration, Inhalation; D000284:Administration, Oral; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage; D058666:Adrenergic beta-2 Receptor Agonists / Q000008:administration & dosage; D000631:Aminopyridines / Q000008:administration & dosage*; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage*; D001549:Benzamides / Q000008:administration & dosage*; D003521:Cyclopropanes / Q000008:administration & dosage; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D005434:Flow Cytometry; D000068298:Fluticasone / Q000008:administration & dosage; D005541:Forced Expiratory Volume; D006115:Greece; D006801:Humans; D008168:Lung / Q000187:drug effects* / Q000201:enzymology / Q000503:physiopathology; D018727:Muscarinic Antagonists / Q000008:administration & dosage; D010587:Phagocytosis / Q000187:drug effects*; D058988:Phosphodiesterase 4 Inhibitors / Q000008:administration & dosage*; D010865:Pilot Projects; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis / Q000188:drug therapy* / Q000201:enzymology / Q000503:physiopathology; D020127:Recovery of Function; D000068299:Salmeterol Xinafoate / Q000008:administration & dosage; D013147:Spirometry; D013997:Time Factors; D000069447:Tiotropium Bromide / Q000008:administration & dosage; D016896:Treatment Outcome; D014797:Vital Capacity
chemical_list: D000305:Adrenal Cortex Hormones; D058666:Adrenergic beta-2 Receptor Agonists; D000631:Aminopyridines; D000893:Anti-Inflammatory Agents; D001549:Benzamides; D003521:Cyclopropanes; D018727:Muscarinic Antagonists; D058988:Phosphodiesterase 4 Inhibitors; C424423:Roflumilast; D000068299:Salmeterol Xinafoate; D000068298:Fluticasone; D000069447:Tiotropium Bromide
keywords: COPD; phosphodiesterase-4 inhibitors; roflumilast