Inhaled fluticasone reduces sputum inflammatory indices in severe bronchiectasis

Am J Respir Crit Care Med. 1998 Sep;158(3):723-7. doi: 10.1164/ajrccm.158.3.9710090.

Abstract

Although corticosteroid therapy might be clinically beneficial for bronchiectasis, very little is known of its effects on the inflammatory and infective markers in bronchiectasis. We have therefore performed a double-blind, placebo-controlled study to evaluate the effects of a 4-wk administration of inhaled fluticasone in bronchiectasis. Twenty-four patients (12 female; mean age 51 yr) were randomized into receiving either inhaled fluticasone (500 microgram twice daily) via the Accuhaler device (n = 12) or placebo. At each visit, spirometry, 24-h sputum volume, sputum leukocyte density, bacterial densities, and concentrations of interleukin (IL)-1beta, IL-8, tumor necrosis factor-alpha (TNF-alpha), and leukotriene B4 (LTB4) were determined. There was a significant (p < 0.05) decrease in sputum leukocyte density and IL-1beta, IL-8, and LTB4 after fluticasone treatment. The fluticasone group had one and the placebo group three episodes of exacerbation. There were no significant changes in spirometry (p > 0.05) or any reported adverse reactions in either group. The results of this study show that high-dose fluticasone is effective in reducing the sputum inflammatory indices in bronchiectasis. Large-scale and long-term studies are indicated to evaluate the effects of inhaled steroid therapy on the inflammatory components in bronchiectasis.

Publication types

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

MeSH terms

  • Administration, Inhalation
  • Administration, Topical
  • Adult
  • Androstadienes / administration & dosage
  • Androstadienes / therapeutic use*
  • Anti-Inflammatory Agents / administration & dosage
  • Anti-Inflammatory Agents / therapeutic use*
  • Bronchiectasis / drug therapy*
  • Bronchiectasis / immunology
  • Bronchiectasis / microbiology
  • Bronchiectasis / pathology
  • Double-Blind Method
  • Female
  • Fluticasone
  • Forced Expiratory Volume / drug effects
  • Glucocorticoids
  • Humans
  • Inflammation
  • Interleukin-1 / analysis
  • Interleukin-8 / analysis
  • Leukocyte Count / drug effects
  • Leukotriene B4 / analysis
  • Male
  • Middle Aged
  • Nebulizers and Vaporizers
  • Peak Expiratory Flow Rate / drug effects
  • Placebos
  • Pseudomonas aeruginosa / isolation & purification
  • Sputum / cytology
  • Sputum / drug effects*
  • Sputum / immunology
  • Sputum / microbiology
  • Tumor Necrosis Factor-alpha / analysis
  • Vital Capacity / drug effects

Substances

  • Androstadienes
  • Anti-Inflammatory Agents
  • Glucocorticoids
  • Interleukin-1
  • Interleukin-8
  • Placebos
  • Tumor Necrosis Factor-alpha
  • Leukotriene B4
  • Fluticasone