Formoterol attenuates neutrophilic airway inflammation in asthma

Chest. 2005 Oct;128(4):1936-42. doi: 10.1378/chest.128.4.1936.

Abstract

Study objectives: 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.

Design: 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.

Patients: 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.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Asthma / blood
  • Asthma / drug therapy*
  • Asthma / physiopathology
  • Bronchodilator Agents / therapeutic use*
  • Double-Blind Method
  • Ethanolamines / therapeutic use*
  • Female
  • Forced Expiratory Volume
  • Formoterol Fumarate
  • Humans
  • Inflammation / prevention & control*
  • Male
  • Methacholine Chloride / therapeutic use
  • Middle Aged
  • Neutrophils / physiology
  • Nitric Oxide / analysis
  • Respiratory Function Tests
  • Vital Capacity

Substances

  • Bronchodilator Agents
  • Ethanolamines
  • Methacholine Chloride
  • Nitric Oxide
  • Formoterol Fumarate