FP AND SALMETEROL IN PREVENTING COPD EXACERBATIONS

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This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Background COPD stands for Chronic Obstructive Pulmonary Disease. COPD is a term that refers mainly to two closely related respiratory disorders that gradually take a person¿??s breath away: chronic bronchitis and/or emphysema associated with airflow obstruction. There is no cure for COPD, only treatment to ease the symptoms of this disease. The easiest way to obtain researchable information is to take a broncoalveolar lavage (BAL) and or endobronchial biopsy sample since they contain cells, proteins and other factors. The purpose of this study is to evaluate the blood and airway of subjects with mild to moderate COPD while undergoing standard treatment to better assess how these standard therapies work. Design and Methods We propose to evaluate blood and airway neutrophil population in COPD patients by examining adhesion and migration in patients with mild to moderate COPD by 1) bronchoscopy with BAL and endobronchial biopsy before the initiation of salmeterol or fluticasone, and 2) again after a period of treatment of 4 weeks. At that point, patients would be placed on the combination of both agents and undergo all procedures again after an additional 4 weeks of treatment. We hypothesize that neutrophils examined in biopsy of patients treated with FP will demonstrate impaired translocation of cytosolic group IVa-phospholipase A2 (gIV-PLA2) and that this effect will be amplified synergistically by addition of salmeterol.