摘要
Background The interleukin （IL）-32/tumor necrosis factor （TNF） a pathway is supposed to play a key role in the amplification of the immune response in chronic obstructive pulmonary disease （COPD） inflammation. Inhaled corticosteroids （ICS） in combination with long-acting I]2-agonists （LABA） have shown airway anti-inflammatory effects in recent studies, but the mechanism is still uncertain. Methods Patients were treated in a randomized, open-labeled, parallel group clinical trial with either a combination of salmeterol xinafoate/fluticasone propionate （SF; Seretide, GlaxoSmithKline） Diskus （50/500 pg twice daily） or ipratropium bromide/salbutamol （IS; Combivent, Boehringer Ingelheim） MDI （42 IJg/240 IJg quartic daily） for 12 weeks. At the start and the end of treatment, induced sputum was collected and the concentration of IL-32 and TNF-a, the number of neutrophUs and eosinophils were measured. Results Following 12 weeks of treatment, a statistically significant fall from baseline in the concentration of TNF-a in sputum （P=0.004） was seen after treatment with SF but not with IS. However, neither treatment had significant effects on the concentration of IL-32 in sputum. There was a decrease from baseline in the number of sputum neutrophils with SF that approached statistical significance （P=0.028） but not with IS, while the number of sputum eosinophils did not change significantly from baseline in either treatment group. There was a statistically significant decline from baseline in the quality of life as assessed by the St George＇s respiratory questionnaire in both the SF （P=0.004） and IS （P=0.030） treatment groups, but no evidence of improvement in lung function was observed in either group. Conclusion The sputum TNF-a and neutrophils, but not IL-32 and macrophages, could be reduced by ICS/LABA treatment, suggesting that IL-32 could be involved in the corticosteroid resistance of COPD inflammation.
Background The interleukin （IL）-32/tumor necrosis factor （TNF） a pathway is supposed to play a key role in the amplification of the immune response in chronic obstructive pulmonary disease （COPD） inflammation. Inhaled corticosteroids （ICS） in combination with long-acting I]2-agonists （LABA） have shown airway anti-inflammatory effects in recent studies, but the mechanism is still uncertain. Methods Patients were treated in a randomized, open-labeled, parallel group clinical trial with either a combination of salmeterol xinafoate/fluticasone propionate （SF; Seretide, GlaxoSmithKline） Diskus （50/500 pg twice daily） or ipratropium bromide/salbutamol （IS; Combivent, Boehringer Ingelheim） MDI （42 IJg/240 IJg quartic daily） for 12 weeks. At the start and the end of treatment, induced sputum was collected and the concentration of IL-32 and TNF-a, the number of neutrophUs and eosinophils were measured. Results Following 12 weeks of treatment, a statistically significant fall from baseline in the concentration of TNF-a in sputum （P=0.004） was seen after treatment with SF but not with IS. However, neither treatment had significant effects on the concentration of IL-32 in sputum. There was a decrease from baseline in the number of sputum neutrophils with SF that approached statistical significance （P=0.028） but not with IS, while the number of sputum eosinophils did not change significantly from baseline in either treatment group. There was a statistically significant decline from baseline in the quality of life as assessed by the St George＇s respiratory questionnaire in both the SF （P=0.004） and IS （P=0.030） treatment groups, but no evidence of improvement in lung function was observed in either group. Conclusion The sputum TNF-a and neutrophils, but not IL-32 and macrophages, could be reduced by ICS/LABA treatment, suggesting that IL-32 could be involved in the corticosteroid resistance of COPD inflammation.
基金
This study was supported by a grant from National Natural Science Foundation of China （No. 30770939）.Acknowledgements： The authors acknowledge the support of the Spirometry Unit of Peking University Third Hospital for lung function tests.
