The Effects of Fluticasone with or without Salmeterol on Systemic Biomarkers of Inflammation in Chronic Obstructive Pulmonary Disease
Small studies have suggested that inhaled corticosteroids can suppress systemic inflammation in chronic obstructive pulmonary disease (COPD). To determine the effect of inhaled corticosteroids with or without long-acting beta(2)-adrenergic agonist on systemic biomarkers of inflammation. We conducted...
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creator | Sin, Don D Man, S. F. Paul Marciniuk, Darcy D Ford, Gordon FitzGerald, Mark Wong, Eric York, Ernest Mainra, Rajesh R Ramesh, Warren Melenka, Lyle S Wilde, Eric Cowie, Robert L Williams, Dave Gan, Wen Q Rousseau, Roxanne ABC (Advair, Biomarkers in COPD) Investigators |
description | Small studies have suggested that inhaled corticosteroids can suppress systemic inflammation in chronic obstructive pulmonary disease (COPD).
To determine the effect of inhaled corticosteroids with or without long-acting beta(2)-adrenergic agonist on systemic biomarkers of inflammation.
We conducted a double-blind randomized placebo-controlled trial across 11 centers (n = 289 patients with FEV(1) of 47.8 +/- 16.2% of predicted) to compare the effects of inhaled fluticasone alone or in combination with salmeterol against placebo on circulating biomarkers of systemic inflammation over 4 weeks. The primary endpoint was C-reactive protein (CRP) level. Secondary molecules of interest were IL-6 and surfactant protein D (SP-D).
Neither fluticasone nor the combination of fluticasone/salmeterol had a significant effect on CRP or IL-6 levels. There was, however, a significant reduction in SP-D levels with fluticasone and fluticasone/salmeterol compared with placebo (P = 0.002). Health status also improved significantly in both the fluticasone and fluticasone/salmeterol groups compared with placebo, driven mostly by improvements in the symptom scores. Changes in the circulating SP-D levels were related to changes in health status scores. FEV(1) improved significantly only in the fluticasone/salmeterol group compared with placebo.
ICS in conjunction with long-acting beta(2)-adrenergic agonist do not reduce CRP or IL-6 levels in serum of patients with COPD over 4 weeks. They do, however, significantly reduce serum SP-D levels. These data suggest that these drugs reduce lung-specific but not generalized biomarkers of systemic inflammation in COPD. |
doi_str_mv | 10.1164/rccm.200709-1356OC |
format | Article |
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To determine the effect of inhaled corticosteroids with or without long-acting beta(2)-adrenergic agonist on systemic biomarkers of inflammation.
We conducted a double-blind randomized placebo-controlled trial across 11 centers (n = 289 patients with FEV(1) of 47.8 +/- 16.2% of predicted) to compare the effects of inhaled fluticasone alone or in combination with salmeterol against placebo on circulating biomarkers of systemic inflammation over 4 weeks. The primary endpoint was C-reactive protein (CRP) level. Secondary molecules of interest were IL-6 and surfactant protein D (SP-D).
Neither fluticasone nor the combination of fluticasone/salmeterol had a significant effect on CRP or IL-6 levels. There was, however, a significant reduction in SP-D levels with fluticasone and fluticasone/salmeterol compared with placebo (P = 0.002). Health status also improved significantly in both the fluticasone and fluticasone/salmeterol groups compared with placebo, driven mostly by improvements in the symptom scores. Changes in the circulating SP-D levels were related to changes in health status scores. FEV(1) improved significantly only in the fluticasone/salmeterol group compared with placebo.
ICS in conjunction with long-acting beta(2)-adrenergic agonist do not reduce CRP or IL-6 levels in serum of patients with COPD over 4 weeks. They do, however, significantly reduce serum SP-D levels. These data suggest that these drugs reduce lung-specific but not generalized biomarkers of systemic inflammation in COPD.</description><identifier>ISSN: 1073-449X</identifier><identifier>EISSN: 1535-4970</identifier><identifier>DOI: 10.1164/rccm.200709-1356OC</identifier><identifier>PMID: 18310480</identifier><language>eng</language><publisher>New York, NY: Am Thoracic Soc</publisher><subject>Administration, Inhalation ; Adrenergic beta-Agonists - administration & dosage ; Adrenergic receptors ; Aged ; Albuterol - administration & dosage ; Albuterol - analogs & derivatives ; Androstadienes - administration & dosage ; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Anti-Inflammatory Agents - administration & dosage ; Biological and medical sciences ; Biomarkers ; Biomarkers - metabolism ; C-Reactive Protein - metabolism ; Canada ; Chronic obstructive pulmonary disease ; Chronic obstructive pulmonary disease, asthma ; Clinical outcomes ; Clinical trials ; Double-Blind Method ; Drug Combinations ; Female ; Fluticasone ; Fluticasone-Salmeterol Drug Combination ; Humans ; Inflammation ; Intensive care medicine ; Interleukin-6 - metabolism ; Male ; Medical sciences ; Middle Aged ; Mortality ; Pneumology ; Proteins ; Pulmonary Disease, Chronic Obstructive - drug therapy ; Pulmonary Disease, Chronic Obstructive - metabolism ; Pulmonary Disease, Chronic Obstructive - pathology ; Pulmonary Surfactant-Associated Protein D - metabolism ; Respiratory Function Tests ; Steroids ; Surfactants ; Treatment Outcome</subject><ispartof>American journal of respiratory and critical care medicine, 2008-06, Vol.177 (11), p.1207-1214</ispartof><rights>2008 INIST-CNRS</rights><rights>Copyright American Thoracic Society Jun 1, 2008</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c394t-1e6577eff4af5c3549e8310bcdc47bdce08291657a38fa69cbe06ee9d74f33ab3</citedby><cites>FETCH-LOGICAL-c394t-1e6577eff4af5c3549e8310bcdc47bdce08291657a38fa69cbe06ee9d74f33ab3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>315,781,785,4026,4027,27929,27930</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=20377668$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/18310480$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Sin, Don D</creatorcontrib><creatorcontrib>Man, S. F. Paul</creatorcontrib><creatorcontrib>Marciniuk, Darcy D</creatorcontrib><creatorcontrib>Ford, Gordon</creatorcontrib><creatorcontrib>FitzGerald, Mark</creatorcontrib><creatorcontrib>Wong, Eric</creatorcontrib><creatorcontrib>York, Ernest</creatorcontrib><creatorcontrib>Mainra, Rajesh R</creatorcontrib><creatorcontrib>Ramesh, Warren</creatorcontrib><creatorcontrib>Melenka, Lyle S</creatorcontrib><creatorcontrib>Wilde, Eric</creatorcontrib><creatorcontrib>Cowie, Robert L</creatorcontrib><creatorcontrib>Williams, Dave</creatorcontrib><creatorcontrib>Gan, Wen Q</creatorcontrib><creatorcontrib>Rousseau, Roxanne</creatorcontrib><creatorcontrib>ABC (Advair, Biomarkers in COPD) Investigators</creatorcontrib><creatorcontrib>ABC (Advair, Biomarkers in COPD) Investigators</creatorcontrib><title>The Effects of Fluticasone with or without Salmeterol on Systemic Biomarkers of Inflammation in Chronic Obstructive Pulmonary Disease</title><title>American journal of respiratory and critical care medicine</title><addtitle>Am J Respir Crit Care Med</addtitle><description>Small studies have suggested that inhaled corticosteroids can suppress systemic inflammation in chronic obstructive pulmonary disease (COPD).
To determine the effect of inhaled corticosteroids with or without long-acting beta(2)-adrenergic agonist on systemic biomarkers of inflammation.
We conducted a double-blind randomized placebo-controlled trial across 11 centers (n = 289 patients with FEV(1) of 47.8 +/- 16.2% of predicted) to compare the effects of inhaled fluticasone alone or in combination with salmeterol against placebo on circulating biomarkers of systemic inflammation over 4 weeks. The primary endpoint was C-reactive protein (CRP) level. Secondary molecules of interest were IL-6 and surfactant protein D (SP-D).
Neither fluticasone nor the combination of fluticasone/salmeterol had a significant effect on CRP or IL-6 levels. There was, however, a significant reduction in SP-D levels with fluticasone and fluticasone/salmeterol compared with placebo (P = 0.002). Health status also improved significantly in both the fluticasone and fluticasone/salmeterol groups compared with placebo, driven mostly by improvements in the symptom scores. Changes in the circulating SP-D levels were related to changes in health status scores. FEV(1) improved significantly only in the fluticasone/salmeterol group compared with placebo.
ICS in conjunction with long-acting beta(2)-adrenergic agonist do not reduce CRP or IL-6 levels in serum of patients with COPD over 4 weeks. They do, however, significantly reduce serum SP-D levels. These data suggest that these drugs reduce lung-specific but not generalized biomarkers of systemic inflammation in COPD.</description><subject>Administration, Inhalation</subject><subject>Adrenergic beta-Agonists - administration & dosage</subject><subject>Adrenergic receptors</subject><subject>Aged</subject><subject>Albuterol - administration & dosage</subject><subject>Albuterol - analogs & derivatives</subject><subject>Androstadienes - administration & dosage</subject><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</subject><subject>Anti-Inflammatory Agents - administration & dosage</subject><subject>Biological and medical sciences</subject><subject>Biomarkers</subject><subject>Biomarkers - metabolism</subject><subject>C-Reactive Protein - metabolism</subject><subject>Canada</subject><subject>Chronic obstructive pulmonary disease</subject><subject>Chronic obstructive pulmonary disease, asthma</subject><subject>Clinical outcomes</subject><subject>Clinical trials</subject><subject>Double-Blind Method</subject><subject>Drug Combinations</subject><subject>Female</subject><subject>Fluticasone</subject><subject>Fluticasone-Salmeterol Drug Combination</subject><subject>Humans</subject><subject>Inflammation</subject><subject>Intensive care medicine</subject><subject>Interleukin-6 - metabolism</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Pneumology</subject><subject>Proteins</subject><subject>Pulmonary Disease, Chronic Obstructive - drug therapy</subject><subject>Pulmonary Disease, Chronic Obstructive - metabolism</subject><subject>Pulmonary Disease, Chronic Obstructive - pathology</subject><subject>Pulmonary Surfactant-Associated Protein D - metabolism</subject><subject>Respiratory Function Tests</subject><subject>Steroids</subject><subject>Surfactants</subject><subject>Treatment Outcome</subject><issn>1073-449X</issn><issn>1535-4970</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2008</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNpdksFu1DAQhiMEoqXwAhyQhUQvKMWOnTg-wraFSpUWqUXiZjneMfFix63tUO0D8N54mxVInGYO3_zzj39X1WuCzwjp2IeotT9rMOZY1IS23Xr1pDomLW1rJjh-WnrMac2Y-H5UvUhpizFpeoKfV0ekpwSzHh9Xv29HQBfGgM4JBYMu3ZytVilMgB5sHlGIjzXMGd0o5yFDDA6FCd3sUgZvNfpkg1fxJ8RHgavJOOW9yrYwdkKrMYapUOsh5TjrbH8B-jo7HyYVd-jcJlAJXlbPjHIJXh3qSfXt8uJ29aW-Xn--Wn28rjUVLNcEupZzMIYp02raMgH7Qwa90YwPGw24bwQpjKK9UZ3QA-AOQGw4M5SqgZ5Up4vuXQz3M6QsvU0anFMThDlJjjlrCWMFfPsfuA1znIo3SYToipumKVCzQDqGlCIYeRdteYqdJFjuE5L7hOSSkFwSKkNvDsrz4GHzb-QQSQHeHQCVtHImqknb9JdrMOW86_rCvV-40f4YH2wEmbxyrsgSqbb7zYTzYkOSpnyDP554q14</recordid><startdate>20080601</startdate><enddate>20080601</enddate><creator>Sin, Don D</creator><creator>Man, S. 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F. Paul ; Marciniuk, Darcy D ; Ford, Gordon ; FitzGerald, Mark ; Wong, Eric ; York, Ernest ; Mainra, Rajesh R ; Ramesh, Warren ; Melenka, Lyle S ; Wilde, Eric ; Cowie, Robert L ; Williams, Dave ; Gan, Wen Q ; Rousseau, Roxanne ; ABC (Advair, Biomarkers in COPD) Investigators</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c394t-1e6577eff4af5c3549e8310bcdc47bdce08291657a38fa69cbe06ee9d74f33ab3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2008</creationdate><topic>Administration, Inhalation</topic><topic>Adrenergic beta-Agonists - administration & dosage</topic><topic>Adrenergic receptors</topic><topic>Aged</topic><topic>Albuterol - administration & dosage</topic><topic>Albuterol - analogs & derivatives</topic><topic>Androstadienes - administration & dosage</topic><topic>Anesthesia. Intensive care medicine. Transfusions. 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Paul</creatorcontrib><creatorcontrib>Marciniuk, Darcy D</creatorcontrib><creatorcontrib>Ford, Gordon</creatorcontrib><creatorcontrib>FitzGerald, Mark</creatorcontrib><creatorcontrib>Wong, Eric</creatorcontrib><creatorcontrib>York, Ernest</creatorcontrib><creatorcontrib>Mainra, Rajesh R</creatorcontrib><creatorcontrib>Ramesh, Warren</creatorcontrib><creatorcontrib>Melenka, Lyle S</creatorcontrib><creatorcontrib>Wilde, Eric</creatorcontrib><creatorcontrib>Cowie, Robert L</creatorcontrib><creatorcontrib>Williams, Dave</creatorcontrib><creatorcontrib>Gan, Wen Q</creatorcontrib><creatorcontrib>Rousseau, Roxanne</creatorcontrib><creatorcontrib>ABC (Advair, Biomarkers in COPD) Investigators</creatorcontrib><creatorcontrib>ABC (Advair, Biomarkers in COPD) Investigators</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Proquest Nursing & Allied Health Source</collection><collection>Health & Medical Collection (Proquest)</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>British Nursing Database</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>PML(ProQuest Medical Library)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>American journal of respiratory and critical care medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Sin, Don D</au><au>Man, S. F. Paul</au><au>Marciniuk, Darcy D</au><au>Ford, Gordon</au><au>FitzGerald, Mark</au><au>Wong, Eric</au><au>York, Ernest</au><au>Mainra, Rajesh R</au><au>Ramesh, Warren</au><au>Melenka, Lyle S</au><au>Wilde, Eric</au><au>Cowie, Robert L</au><au>Williams, Dave</au><au>Gan, Wen Q</au><au>Rousseau, Roxanne</au><au>ABC (Advair, Biomarkers in COPD) Investigators</au><aucorp>ABC (Advair, Biomarkers in COPD) Investigators</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The Effects of Fluticasone with or without Salmeterol on Systemic Biomarkers of Inflammation in Chronic Obstructive Pulmonary Disease</atitle><jtitle>American journal of respiratory and critical care medicine</jtitle><addtitle>Am J Respir Crit Care Med</addtitle><date>2008-06-01</date><risdate>2008</risdate><volume>177</volume><issue>11</issue><spage>1207</spage><epage>1214</epage><pages>1207-1214</pages><issn>1073-449X</issn><eissn>1535-4970</eissn><abstract>Small studies have suggested that inhaled corticosteroids can suppress systemic inflammation in chronic obstructive pulmonary disease (COPD).
To determine the effect of inhaled corticosteroids with or without long-acting beta(2)-adrenergic agonist on systemic biomarkers of inflammation.
We conducted a double-blind randomized placebo-controlled trial across 11 centers (n = 289 patients with FEV(1) of 47.8 +/- 16.2% of predicted) to compare the effects of inhaled fluticasone alone or in combination with salmeterol against placebo on circulating biomarkers of systemic inflammation over 4 weeks. The primary endpoint was C-reactive protein (CRP) level. Secondary molecules of interest were IL-6 and surfactant protein D (SP-D).
Neither fluticasone nor the combination of fluticasone/salmeterol had a significant effect on CRP or IL-6 levels. There was, however, a significant reduction in SP-D levels with fluticasone and fluticasone/salmeterol compared with placebo (P = 0.002). Health status also improved significantly in both the fluticasone and fluticasone/salmeterol groups compared with placebo, driven mostly by improvements in the symptom scores. Changes in the circulating SP-D levels were related to changes in health status scores. FEV(1) improved significantly only in the fluticasone/salmeterol group compared with placebo.
ICS in conjunction with long-acting beta(2)-adrenergic agonist do not reduce CRP or IL-6 levels in serum of patients with COPD over 4 weeks. They do, however, significantly reduce serum SP-D levels. These data suggest that these drugs reduce lung-specific but not generalized biomarkers of systemic inflammation in COPD.</abstract><cop>New York, NY</cop><pub>Am Thoracic Soc</pub><pmid>18310480</pmid><doi>10.1164/rccm.200709-1356OC</doi><tpages>8</tpages></addata></record> |
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subjects | Administration, Inhalation Adrenergic beta-Agonists - administration & dosage Adrenergic receptors Aged Albuterol - administration & dosage Albuterol - analogs & derivatives Androstadienes - administration & dosage Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Anti-Inflammatory Agents - administration & dosage Biological and medical sciences Biomarkers Biomarkers - metabolism C-Reactive Protein - metabolism Canada Chronic obstructive pulmonary disease Chronic obstructive pulmonary disease, asthma Clinical outcomes Clinical trials Double-Blind Method Drug Combinations Female Fluticasone Fluticasone-Salmeterol Drug Combination Humans Inflammation Intensive care medicine Interleukin-6 - metabolism Male Medical sciences Middle Aged Mortality Pneumology Proteins Pulmonary Disease, Chronic Obstructive - drug therapy Pulmonary Disease, Chronic Obstructive - metabolism Pulmonary Disease, Chronic Obstructive - pathology Pulmonary Surfactant-Associated Protein D - metabolism Respiratory Function Tests Steroids Surfactants Treatment Outcome |
title | The Effects of Fluticasone with or without Salmeterol on Systemic Biomarkers of Inflammation in Chronic Obstructive Pulmonary Disease |
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