Inhaled Corticosteroids Do Not Influence the Early Inflammatory Response and Clinical Presentation of Hospitalized Subjects With COPD Exacerbation.

BACKGROUND: Inhaled corticosteroids are anti-inflammatory medications that can down-regulate the immunologic response in patients with COPD; however, their role at onset of COPD exacerbation is still not understood. The aim of this study was to assess the early inflammatory response and clinical pre...

Descripción completa

Detalles Bibliográficos
Publicado en:Respiratory Care Vol. 59; no. 10; pp. 1550 - 1560
Autores principales: Crisafulli, Ernesto, Guerrero, Mónica, Menéndez, Rosario, Huerta, Arturo, Martinez, Raquel, Gimeno, Alexandra, Soler, Néstor, Torres, Antoni
Formato: research tables/charts Journal Article
Publicado: Mary Ann Liebert, Inc. Oct2014
Acceso en línea:Ver este registro en EBSCOhost
fields @attributes:
  recordID: 1
pdfLink:
plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=103899551&site=ehost-live
header:
  @attributes:
    shortDbName: ccm
    uiTerm: 103899551
    longDbName: CINAHL Complete
    uiTag: AN
  controlInfo:
    bkinfo:
    dissinfo:
    jinfo:
      jid:
        00201324
        4GG
      jtl: Respiratory Care
      issn: 00201324
      maglogo: N
    pubinfo:
      dt: Oct2014
      vid: 59
      iid: 10
      pid: 1365
      pub: Mary Ann Liebert, Inc.
      place: New Rochelle, New York
    artinfo:
      ui:
        103899551
        98596493
        10.4187/respcare.03036
        NLM25074943
        103899551
      ppf: 1550
      ppct: 10
      formats:
        fmt:
          @attributes:
            type: P
      tig:
        atl: Inhaled Corticosteroids Do Not Influence the Early Inflammatory Response and Clinical Presentation of Hospitalized Subjects With COPD Exacerbation.
      aug:
        au:
          Crisafulli, Ernesto
          Guerrero, Mónica
          Menéndez, Rosario
          Huerta, Arturo
          Martinez, Raquel
          Gimeno, Alexandra
          Soler, Néstor
          Torres, Antoni
        affil: Cardio-Thoracic Department, Pneumology and Respiratory Intensive Care Unit, Carlo Poma Hospital, Mantua, Italy
      sug:
        subj:
          Pulmonary Disease, Chronic Obstructive
          Disease Exacerbation Symptoms
          Disease Exacerbation Drug Therapy
          Inflammation Immunology
          Adrenal Cortex Hormones Immunology
          Administration, Inhalation
          Biological Markers Blood
          Human
          Inpatients
          Prospective Studies
          Descriptive Statistics
          Academic Medical Centers
          Spain
          Funding Source
          Sputum Microbiology
          Female
          Male
          Aged
          Aged, 80 and Over
          Middle Age
          T-Tests
          Mann-Whitney U Test
          Kruskal-Wallis Test
          Fisher's Exact Test
          Data Analysis Software
          Logistic Regression
          Aged: 65+ years
          Aged, 80 & over
          Middle Aged: 45-64 years
          Female
          Male
      ab: BACKGROUND: Inhaled corticosteroids are anti-inflammatory medications that can down-regulate the immunologic response in patients with COPD; however, their role at onset of COPD exacerbation is still not understood. The aim of this study was to assess the early inflammatory response and clinical presentation of patients with COPD exacerbation mediated by inhaled corticosteroids. METHODS: Prospective data were collected on 123 hospitalized subjects with COPD exacerbation over a 30-month period at 2 Spanish university hospitals. Based on domiciliary use, comparative analyses were performed between subjects who did not use inhaled corticosteroids (n = 58) and subjects who did (n = 65). Measurements of serum biomarkers were recorded on admission to the hospital (day 1) and on day 3; clinical, physiological, microbiological, and severity data and mortality/readmission rates were also recorded. RESULTS: At days 1 and 3, both groups showed a similar inflammatory response; fluticasone produced lower levels of interleukin-8 compared with budesonide (P < .01). All clinical features considered were similar in the 2 groups; multivariate analysis predicting clinical complications on hospitalization showed air-flow obstruction severity as the only predictive factor (odds ratio 3.13, 95% CI 1.13-8.63, P = .02). CONCLUSIONS: Our study demonstrates a lack of inhaled corticosteroid influence in the early systemic inflammatory response to and clinical presentation of COPD exacerbation.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
    refInfo:
    holdings:
      @attributes:
        islocal: N