Fluticasone tackles infection of airway

COPD and asthma drug fluticasone reduces disease exacerbations because it tackles airway infection, as well as inflammation, a study suggests.

Fluticasone is known to reduce inflammation in the lungs as well as the exacerbations that COPD patients frequently suffer. Researchers from the University of the Balearic Islands looked at whether it might also reduce the rate of infection with bacteria such as Streptococcus pneumoniae and Haemophilus influenzae. Such infections are often found in patients experiencing exacerbations.

Part of the cell surface of these bacteria binds to the platelet-activating factor receptor (PAFR) on the cells lining the airways and studies have shown that steroids, such as fluticasone, reduce expression of PAFR.

The researchers first demonstrated that fluticasone reduced PAFR expression in human airway epithelial cells. They then studied airway infections in mice and showed that fluticasone reduced invasion of the airway epithelial cells by S pneumoniae and H influenzae.

Further experiments showed that it was the drug's action on PAFR that causes this effect.

'These novel molecular effects can explain the reduction in the frequency of exacerbations observed in patients treated with fluticasone propionate,' the authors said.

tom.moberly@haymarket.com

Eur Respir J 2008; 32: 1,283-88

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