Abstract
Chronic obstructive pulmonary disease is a mainly tobacco-related disease currently representing the fourth highest cause of mortality worldwide. It is characterized by progressive chronic airway obstruction, the underlying pathogenic mechanism being inflammatory. Currently, apart from neutrophils and macrophages, there is an evolving role of T-lymphocytes, especially in smokers who develop chronic obstructive pulmonary disease. Oral steroids produce a clinical improvement in approximately 10% of chronic obstructive pulmonary disease patients. Inhaled steroids, such as fluticasone propionate, failed to stop lung function deterioration, but reduced the health status decline and number of exacerbations. Its effect on the inflammatory process was analysed in the study authored by Hattotuwa et al. The primary outcome was the effect of fluticasone propionate on the inflammatory cells present in the bronchial biopsies. Secondary outcomes were the symptoms, lung function decline and number of exacerbations. Fluticasone propionate had a partial effect on inflammation did not influence the progressive airway obstruction, partially improved the symptoms and reduced the number of exacerbations.