降低痰液嗜中性粒细胞和嗜酸性粒细胞数量的PDE4抑制剂roflumilast慢性阻塞性肺病患者。

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Grootendorst特区Gauw SA Verhoosel RM,斯德克已PJ, Hospers JJ, Bredenbroker D, Bethke TD, KF Hiemstra PS,瑞芭

降低痰液嗜中性粒细胞和嗜酸性粒细胞数量的PDE4抑制剂roflumilast慢性阻塞性肺病患者。

胸腔。2007年12月,62 (12):1081 - 7。Epub 2007年6月15日。

PubMed ID

17573446 (在PubMed

]

文摘

背景:Roflumilast目标口服每日一次管理的磷酸二酯酶4 (PDE4)抑制剂与临床疗效在慢性阻塞性肺疾病(COPD)。使用roflumilast体外研究的结果表明,抗炎作用,可能适用于治疗慢性阻塞性肺病。方法:在一个交叉研究中,38 COPD患者(平均年龄(SD) 63.1(7.0)年,post-bronchodilator用力呼气量在1 s (FEV(1)) 61.0(12.6) %预测)收到500 microg roflumilast或安慰剂为4周每天一次。诱导痰液样本收集前后2和4周的治疗。微分和绝对细胞计数测定在整个痰液样本。炎症标志物痰上层清液和血液中决定。肺量测定法进行每周。结果:Roflumilast显著降低中性粒细胞和嗜酸性粒细胞的绝对数量/ g痰与安慰剂比较35.5% (95% CI 15.6%至50.7%;p = 0.002)和50.0%(95%可信区间26.8%到65.8%;分别为p < 0.001)。 The relative proportion of sputum neutrophils and eosinophils was not affected by treatment (p>0.05). Levels of soluble interleukin-8, neutrophil elastase, eosinophil cationic protein and alpha(2)-macroglobulin in sputum and the release of tumour necrosis factor alpha from blood cells were significantly reduced by roflumilast compared with placebo treatment (p<0.05 for all). Post-bronchodilator FEV(1) improved significantly during roflumilast compared with placebo treatment with a mean difference between treatments of 68.7 ml (95% CI 12.9 to 124.5; p = 0.018). CONCLUSION: PDE4 inhibition by roflumilast treatment for 4 weeks reduced the number of neutrophils and eosinophils, as well as soluble markers of neutrophilic and eosinophilic inflammatory activity in induced sputum samples of patients with COPD. This anti-inflammatory effect may in part explain the concomitant improvement in post-bronchodilator FEV(1).

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药物

Roflumilast