Evaluation of Inhaled Corticosteroid Efficacy by Electron Microscopy in Patients with Chronic Obstructive Pulmonary Disease

Objective: Inhaled corticosteroids definitely alleviate bronchial mucosal inflammation in patients with asthma.Nevertheless, the data regarding their anti-inflammatory effects in patients with chronic obstructive pulmonary disease (COPD) is controversial.The aim of the present study is to assess the efficacy of inhaled corticosteroids in reduction of inflammatory response in patients with COPD.Methods: A total of 14 subjects with the new diagnosis of mild to moderate COPD (forced expiratory volume in one second [FEV 1 ] >50% of predicted value) were prospectively enrolled.Endobronchial sampling with bronchoscopic intervention was performed before and after three months of treatment with inhaled fluticasone propionate (FP) (500 μg twice daily).Histopathological evaluations were performed with electron microscopy and the anti-inflammatory effects of the medicine were evaluated.Differences in arterial blood gas analysis and pulmonary functions were also investigated.Results: Three months treatment with FP revealed regression of the epithelial edema, decrease in the thickness of basal lamina, augmentation of the cilliary structures, reduction in the number of macrophages and lymphocytes in biopsy samples.Significant improvement of pulmonary functions was remarkable in spirometric test results.The difference in arterial blood gas analyses was not significant.Conclusion: Treatment with FP provided significant anti-inflammatory effects on endobronchial tissue samples and remarkable improvement in pulmonary functions in patients with COPD.