copd抗炎治疗进展新团泊湖.ppt

* * * * 关键信息： COPD是以炎症为核心的疾病， 在气道炎症的驱动下，发生了结构改变、黏液纤毛功能障碍，导致了气流受限以及全身效应， 临床表现为：肺功能下降…………..直至死亡 * In this study by Hogg et al, the small airways from 159 patients with sugically resected iung tissue was assessed. Subjects were from patients who required surgical treatment of small peripheral lung tumours and patients enrolled in the National Emphysema Treatment Trial (NETT). 39 patients had stage 0 (at risk), 39 stage 1, 22 stage 2, 16 stage 3 and 43 patients had stage 4 COPD according to the GOLD classification. The data showed that progression of COPD was strongly associated with an increase in the volume of tissue in the wall (p0.001) and the accumulation of inflammatory mucous exudates in the lumen (p0.001) of the airways. In addition, the percentage of airways containing polymorphonuclear neutrophils (p0.001), macrophages (p0.001), CD4+ cells (p=0.02) and CD8+ cells (p=0.038) increased as COPD progressed as did the absolute volume of CD8+ cells. It is noticeable that inflammation is present, even in the early stages of COPD Hogg JC, Chu F, Utokaparch S, et al. The nature of small-airway obstruction in chronic obstructive pulmonary disease. N Engl J Med 2004; 350: 2645-2653 * * * * * * Salmeterol and FP suppress IL-8 release induced by CSM neutrophils were isolated from buffy coats and pretreated for 90 min with FP 10–11–10–7 M (a) or salmeterol 10–9–10–5 M (b) and then stimulated for 9 h with CSM (0.06 OD) The supernatants were harvested and subjected to ELISA methods as described on “Materials and methods”. Data shown are mean±SEM of three independent experiments. Asterisk indicates significant differences between medium-treated cells and cells treated with CSM (***p0.0001) and number sign represents the significance between cells treated with CSM alone and CSM with S or FP (#p0.05 and ##p0.01). S and FP indicate salmeterol and FP, respectively Fig. 4. Effect of fluticasone on cigarette smoke medium-induced IL-8 release. Macrophages were pretreated wit