tailieunhanh - Báo cáo y học: "Airway inflammation and mannitol challenge test in COPD"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học 'Respiratory Research cung cấp cho các bạn kiến thức về ngành y đề tài:"Airway inflammation and mannitol challenge test in COPD. | de Nijs et al. Respiratory Research 2011 12 11 http content 12 1 11 RESPIRATORY RESEARCH RESEARCH Open Access Airway inflammation and mannitol challenge test in COPD 1 1 12 1 3 12 Selma B de Nijs Niki Fens Rene Lutter Erica Dijkers Frans H Krouwels Barbara S Smids-Dierdorp Reindert P van Steenwijk1 Peter J Sterk1 Abstract Background Eosinophilic airway inflammation has successfully been used to tailor anti-inflammatory therapy in chronic obstructive pulmonary disease COPD . Airway hyperresponsiveness AHR by indirect challenges is associated with airway inflammation. We hypothesized that AHR to inhaled mannitol captures eosinophilia in induced sputum in COPD. Methods Twenty-eight patients age 58 yr packyears 40 post-bronchodilator FEV1 77 predicted no inhaled steroids 4 wks with mild-moderate COPD GOLD I-II completed two randomized visits with hypertonic saline-induced sputum and mannitol challenge including sputum collection . AHR to mannitol was expressed as response-dose-ratio RDR and related to cell counts ECP MPO and IL-8 levels in sputum. Results There was a positive correlation between RDR to mannitol and eosinophil numbers r p and level of IL-8 r p in hypertonic saline-induced sputum. Furthermore significant correlations were found between RDR and eosinophil numbers r p level of ECP r p IL-8 r p and MPO r p in sputum collected after mannitol challenge. ROC-curves showed 60 sensitivity and 100 specificity of RDR for eosinophils in mannitol-induced sputum. Conclusions In mild-moderate COPD mannitol hyperresponsiveness is associated with biomarkers of airway inflammation. The high specificity of mannitol challenge suggests that the test is particularly suitable to exclude eosinophilic airways inflammation which may facilitate individualized treatment in COPD. Trial registration Netherlands Trial Register NTR NTR1283 Introduction Chronic obstructive .

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