UNLABELLED: Bronchiolitis Obliterans Syndrome (BOS) remains a major cause of long term morbidity and mortality in lung transplantation, and occurs despite significant immunosuppression. Airway inflammation is thought to precede the development of BOS. OBJECTIVES: To examine the effect of inhaled corticosteroids on airway inflammation and the development of BOS in lung transplant recipients. METHODS:30 patients were recruited and randomised in a double blind fashion to receive either 750 micrograms Fluticasone propionate (FP) twice daily or an identical appearing placebo for 3 months. BAL cell counts and differentials were performed at time 0 and after 3 months treatment. Lung function was assessed at each time point using spirometry. RESULTS:24 patients were felt to be stable and free from infection at both time points and thus included in the analysis. There was a significant reduction in total cell count in BAL fluid after treatment with 3 months FP compared to 3 months placebo, however no change in cell differentials nor lung function was found. DISCUSSION: Despite a reduction in total cell numbers in BAL fluid, lung function was not altered over the 3 months of treatment. It may be that longer treatment is required to see an effect.
RCT Entities:
UNLABELLED: Bronchiolitis Obliterans Syndrome (BOS) remains a major cause of long term morbidity and mortality in lung transplantation, and occurs despite significant immunosuppression. Airway inflammation is thought to precede the development of BOS. OBJECTIVES: To examine the effect of inhaled corticosteroids on airway inflammation and the development of BOS in lung transplant recipients. METHODS: 30 patients were recruited and randomised in a double blind fashion to receive either 750 micrograms Fluticasone propionate (FP) twice daily or an identical appearing placebo for 3 months. BAL cell counts and differentials were performed at time 0 and after 3 months treatment. Lung function was assessed at each time point using spirometry. RESULTS: 24 patients were felt to be stable and free from infection at both time points and thus included in the analysis. There was a significant reduction in total cell count in BAL fluid after treatment with 3 months FP compared to 3 months placebo, however no change in cell differentials nor lung function was found. DISCUSSION: Despite a reduction in total cell numbers in BAL fluid, lung function was not altered over the 3 months of treatment. It may be that longer treatment is required to see an effect.
Authors: Kirsten M Williams; Guang-Shing Cheng; Iskra Pusic; Madan Jagasia; Linda Burns; Vincent T Ho; Joseph Pidala; Jeanne Palmer; Laura Johnston; Sebastian Mayer; Jason W Chien; David A Jacobsohn; Steven Z Pavletic; Paul J Martin; Barry E Storer; Yoshihiro Inamoto; Xiaoyu Chai; Mary E D Flowers; Stephanie J Lee Journal: Biol Blood Marrow Transplant Date: 2015-10-22 Impact factor: 5.742