Influence of Inhaled Corticosteroids on Bronchial Inflammation and Pulmonary Function in Chronic Obstructive Pulmonary Disease with Moderate Obstruction

Inflammation in the bronchial respiratory tract and lung parenchyma underlies the pathogenesis of chronic obstructive pulmonary disease (COPD). It consists of effector cell infiltration, changes in reticular basement membrane (RBM) thickness, and the content of inflammatory mediators. The aim of this study was to assess the influence of inhaled corticosteroids (ICS) on the number of inflammatory cells and RBM thickness in bronchial biopsies, and pulmonary function in patients with moderate COPD. Twenty four patients with newly diagnosed COPD were included into the study. Pulmonary function tests and fiber optic bronchoscopy with bronchial biopsies were performed before and after 12-month treatment in two groups: ICS-group (LABA plus anticholinergics) and ICS + group (LABA plus anticholinergics plus ICS). We found that the addition of inhaled corticosteroids to the therapeutic regimen contributed to a reduction of RBM thickness, inflammation, and lung hyperinflation. The intensity of bronchial inflammatory infiltration had little effect on lung function. In conclusion, RBM thickness, an airway wall remodeling element, does not significantly affect the degree of airflow limitation.