Decreased levels of myeloperoxidase in induced sputum of patients with COPD after treatment with oral glucocorticoids.

BACKGROUND: Inhaled glucocorticoids may decrease exacerbations in some patients with COPD, and oral glucocorticoids may improve FEV(1) and shorten hospital stay during exacerbations. The mechanism of these improvements is unknown. This study examines the effect of oral glucocorticoids on markers of neutrophilic airway inflammation. METHODS: Eighteen patients with COPD received oral prednisone, 0.5 mg/kg/d for 2 weeks. Clinical status, lung function measurements, and sputum induction were performed before and after treatment with oral prednisone. Levels of the neutrophil chemoattractant (interleukin-8 [IL-8]) and neutrophil activation marker (myeloperoxidase [MPO]) were measured in the supernatant of induced sputum by enzyme-linked immunosorbent assay. RESULTS: Levels of MPO decreased significantly after treatment with prednisone (p = 0.0004): before treatment median, 2.54 microg/mL (range, 1.49 to 12.58 microg/mL); after treatment median, 1.79 microg/mL (range, 1.32 to 3.57 microg/mL). Treatment with prednisone did not influence the levels of IL-8. CONCLUSIONS: The treatment of patients with COPD with oral glucocorticoids decreases the activation of neutrophils, which may be partially responsible for clinical improvement in these patients.

[Influence of orthopnoea position on spirometric and plethysmographic parameters in patients with chronic obstructive pulmonary disease ]. / Wplyw pozycji orthopnoe na wskazniki spirometryczne i pletyzmograficzne u chorych na przewlekla obturacyjna chorobe pluc (POChP).

Chronic obstructive pulmonary disease (COPD) is characterized by the lack or only slight reversibility of obstruction which can be assessed by spirometry after inhalation of short-acting beta 2-mimetic (e.g. Salbutamol). The aim of the study was to determine if subjective decrease in dyspnoea sensation notified by COPD patients in orthopnoea position is reflected in spirometry and plethysmography. The study was carried out in the group of 30 patients with COPD (FEV1 = 30-70% of predicted value) as well as in 30 sex- and age-matched non-smoking healthy subjects. We observed the increase of spirometric parameters (FEV1, FEV1%VC, FEF75, PEF) and the decrease of plethysmographic parameters (RTOT, RV, RV%TLC) after the change from the initial to orthopnoea position (p < 0.001). The obtained results show that orthopnoea position leads to the decline of obstruction degree, pulmonary hyperinflation and the decrease of dyspnoea sensation.

[Transfusion related acute lung injury (TRIALI)--case report]. / Ostre potransfuzyjne uszkodzenie pluc--opis przypadku.

Transfusion related acute lung injury (TRALI) is a relatively rare but potentially severe complication of blood transfusion. Acute respiratory distress syndrome in this case is due to noncardiogenic pulmonary oedema without hypervolaemia. The passive transfer of anti-human leukocyte antigen (HLA) or antineutrophil antibodies in the donated blood products are responsible for the pathophysiological process in TRALI. Less commonly, the recipient may have antibodies which interact with white cells in the donor products. Most commonly TRALI may appear during whole blood, packed cells and fresh frozen plasma transfusions. The increased risk of TRALI is observed when a donors are multiparous women and additionally when older, stored blood components are used for transfusion. The only therapy which can be recommended as standard treatment of TRALI is ventilatory assistance and saline infusion. The case of 70-year-old woman with the fracture of the right femoral bone, who developed TRALI after transfusion of packed red cells is presented in the paper. It is the first case of TRIALI reported in our department.