Lung rejectionEffect of inhaled fluticasone propionate on BAL TGF-β1 and bFGF concentrations in clinically stable lung transplant recipients☆
Section snippets
Study design
A double-blind, randomized, placebo-controlled, and parallel-group study was conducted. Patients received either 750 μg inhaled FP or inhaled placebo twice a day for 3 months, in addition to conventional immunosuppression. The standardized immunosuppression consisted of cyclosporine (to achieve a trough blood concentration of 250–300 μg/liter by enzyme-multiplied immunoassay technique [Syya, CA]); azathioprine (1–2 mg/kg, maintaining white blood cells >5 × 109/liter); and prednisolone, tapering
Subject demography and clinical characteristics
We recruited 28 single LTRs (15 in FP group, 13 in placebo group) who underwent transplantation between April 1997 and May 1999 and who were at an average of 145 ± 70 days after transplantation. All patients had bronchoscopy and lung function measurements on 2 occasions. We found no significant difference in age (p = 0.17), FEV1 (p = 0.80), and best FEV1% after transplantation (p = 0.27) between FP and placebo groups (Table 1). However the sex distribution (10 women in the FP group vs 3 women
Discussion
In this double-blind, randomized, placebo-controlled study, we evaluated the effects of high-dose, inhaled FP on BAL TGF-β1 and bFGF concentrations in clinically stable LTRs during a 3-month period of treatment. Inhaled FP added to the conventional immunosuppressant regimen had little effect on the concentrations of bFGF in BAL fluid from the studied subjects. Bronchoalveolar lavage fluid TGF-β1 concentrations were significantly greater before treatment in the single LTRs than in controls, and
Acknowledgements
The authors thank Christopher Ward for assistance in the administration of this study.
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Grant support from the National Health and Medical Research Council of Australia and Glaxo Welcome R&D.