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Published ahead of print on September 17, 2002, doi:10.1164/rccm.200204-298OC

Am. J. Respir. Crit. Care Med., Volume 167, Number 1, January 2003, 24-31

A more recent version of this article appeared on January 1, 2003
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Submitted on April 8, 2002
Accepted on September 12, 2002

Impaired Inhibition by Dexamethasone of Cytokine Release by Alveolar Macrophages from COPD Patients

Sarah V Culpitt1, Duncan F Rogers1, Pallav Shah1, Carmen De Matos1, Richard E Russell1, Louise E Donnelly1*, and Peter J Barnes1

1 Thoracic Medicine, National Heart & Lung Institute, London, United Kingdom

* To whom correspondence should be addressed. E-mail: l.donnelly{at}ic.ac.uk.

Chronic obstructive pulmonary disease (COPD) is characterized by inflammation of the respiratory tract in which macrophages are the predominant inflammatory cell and for which the efficacy of treatment with corticosteroids is controversial. We investigated the effect of dexamethasone on basal and interleukin (IL)-1ß or cigarette smoke media (CSM) stimulated release of IL-8 and granulocyte macrophage-colony stimulating factor (GM-CSF) by bronchoalveolar lavage macrophages from cigarette smokers and patients with COPD (n=15). Basal release of IL-8 was ~5-fold greater in COPD patients than smokers, whereas GM-CSF was similar for each group. IL-1ß and CSM increased IL-8 and GM-CSF release by macrophages from both smokers and COPD patients. Dexamethasone did not inhibit basal or stimulated IL-8 release from macrophages from COPD patients, but inhibited release in smokers. In contrast, basal and IL-1ß stimulated GM-CSF release, but not CSM stimulated release, was inhibited by dexamethasone. We conclude that the lack of efficacy of corticosteroids in COPD might be due to the relative steroid insensitivity of macrophages in the respiratory tract.


Key words: corticosteroid; cigarette smoke; chronic obstructive pulmonary disease




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