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Inhaled corticosteroid normalizes some but not all airway vascular remodeling in COPD

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posted on 2023-05-19, 05:21 authored by Soltani, A, Eugene WaltersEugene Walters, Reid, DW, Shukla, SD, Nowrin, K, Ward, C, Muller, HK, Sukhwinder SohalSukhwinder Sohal
© 2016 Soltani et al.Background: This study assessed the effects of inhaled corticosteroid (ICS) on airway vascular remodeling in chronic obstructive pulmonary disease (COPD). Methods: Thirty-four subjects with mild-to-moderate COPD were randomly allocated 2:1 to ICS or placebo treatment in a double-blinded clinical trial over 6 months. Available tissue was compared before and after treatment for vessel density, and expression of VEGF, TGF-β1, and TGF-β1-related phosphorylated transcription factors p-SMAD 2/3. This clinical trial has been registered and allocated with the Australian New Zealand Clinical Trials Registry (ANZCTR) on 17/10/2012 with reference number ACTRN12612001111864. Results: There were no significant baseline differences between treatment groups. With ICS, vessels and angiogenic factors did not change in hypervascular reticular basement membrane, but in the hypovascular lamina propria (LP), vessels increased and this had a proportionate effect on lung air trapping. There was modest evidence for a reduction in LP vessels staining for VEGF with ICS treatment, but a marked and significant reduction in p-SMAD 2/3 expression. Conclusion: Six-month high-dose ICS treatment had little effect on hypervascularity or angiogenic growth factors in the reticular basement membrane in COPD, but normalized hypovascularity in the LP, and this was physiologically relevant, though accompanied by a paradoxical reduction in growth factor expression.

History

Publication title

International Journal of COPD

Volume

11

Pagination

2359-2367

ISSN

1178-2005

Department/School

Tasmanian School of Medicine

Publisher

Dove Medical Press Ltd.(Dovepress)

Place of publication

United Kingdom

Rights statement

Copyright 2016 Soltani et al. Licensed under Creative Commons Attribution-NonCommercial 3.0 Unported (CC BY-NC 3.0) https://creativecommons.org/licenses/by-nc/3.0/

Repository Status

  • Open

Socio-economic Objectives

Clinical health not elsewhere classified

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