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...
| Publicado en: | Respiratory Care Vol. 59; no. 10; pp. 1550 - 1560 |
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| Autores principales: | , , , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Mary Ann Liebert, Inc.
Oct2014
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| 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 |
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