Dataset Information

Lower corticosteroid skin blanching response is associated with severe COPD.

ABSTRACT:

Background

Chronic obstructive pulmonary disease (COPD) is characterized by chronic airflow limitation caused by ongoing inflammatory and remodeling processes of the airways and lung tissue. Inflammation can be targeted by corticosteroids. However, airway inflammation is generally less responsive to steroids in COPD than in asthma. The underlying mechanisms are yet unclear. This study aimed to assess whether skin corticosteroid insensitivity is associated with COPD and COPD severity using the corticosteroid skin blanching test.

Methods

COPD patients GOLD stage I-IV (n?=?27, 24, 22, and 16 respectively) and healthy never-smokers and smokers (n?=?28 and 56 respectively) were included. Corticosteroid sensitivity was assessed by the corticosteroid skin blanching test. Budesonide was applied in 8 logarithmically increasing concentrations (0-100 ?g/ml) on subject's forearm. Assessment of blanching was performed after 7 hours using a 7-point scale (normal skin to intense blanching). All subjects performed spirometry and body plethysmography.

Results

Both GOLD III and GOLD IV COPD patients showed significantly lower skin blanching responses than healthy never-smokers and smokers, GOLD I, and GOLD II patients. Their area under the dose-response curve values of the skin blanching response were 586 and 243 vs. 1560, 1154, 1380, and 1309 respectively, p<0.05. Lower FEV1 levels and higher RV/TLC ratios were significantly associated with lower skin blanching responses (p?=?0.001 and p?=?0.004 respectively). GOLD stage I, II, III and IV patients had similar age and packyears.

Conclusions

In this study, severe and very severe COPD patients had lower skin corticosteroid sensitivity than mild and moderate COPD patients and non-COPD controls with comparable age and packyears. Our findings together suggest that the reduced skin blanching response fits with a subgroup of COPD patients that has an early-onset COPD phenotype.

SUBMITTER: Hoonhorst SJ

PROVIDER: S-EPMC3951419 | biostudies-literature | 2014

REPOSITORIES: biostudies-literature

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Publications

Lower corticosteroid skin blanching response is associated with severe COPD.

Hoonhorst Susan J M SJ ten Hacken Nick H T NH Lo Tam Loi Adèle T AT Koenderman Leo L Lammers Jan Willem J JW Telenga Eef D ED Boezen H Marike HM van den Berge Maarten M Postma Dirkje S DS

PloS one 20140312 3

<h4>Background</h4>Chronic obstructive pulmonary disease (COPD) is characterized by chronic airflow limitation caused by ongoing inflammatory and remodeling processes of the airways and lung tissue. Inflammation can be targeted by corticosteroids. However, airway inflammation is generally less responsive to steroids in COPD than in asthma. The underlying mechanisms are yet unclear. This study aimed to assess whether skin corticosteroid insensitivity is associated with COPD and COPD severity usin ...[more]

PMID: 24622644

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Dataset Information

Lower corticosteroid skin blanching response is associated with severe COPD.

Background

Methods

Results

Conclusions

Publications

Lower corticosteroid skin blanching response is associated with severe COPD.

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