Chronic obstructive pulmonary disease (COPD) is characterized by a neutrophilic airway inflammation that can be demonstrated by examination of induced sputum. Theophylline has antiinflammatory effects in asthma, and in the present study we investigated whether a similar effect occurs in COPD patients treated with low doses of theophylline. Twenty-five patients with COPD were treated with theophylline (plasma level of 9–11 mg/L) for 4 weeks in a placebo-controlled, randomized, double-blind crossover study. Theophylline was well tolerated. Induced sputum inflammatory cells, neutrophils, interleukin-8, myeloperoxidase, and lactoferrin were all significantly reduced by about 22% by theophylline. Neutrophils from subjects treated with theophylline showed reduced chemotaxis to N-formyl-met-leu-phe (∼ 28%) and interleukin-8 (∼ 60%). Neutrophils from a healthy donor showed reduced chemotaxis (∼ 30%) to induced sputum samples obtained during theophylline treatment. These results suggest that theophylline has antiinflammatory properties that may be useful in the long-term treatment of COPD.
Neutrophilic inflammation is a major feature of COPD. Several factors in bronchial secretions have been identified as chemoattractants for neutrophils. The present study was designed to assess the contribution of interleukin (IL)-8 and leukotriene B4 (LTB4) to neutrophil chemotaxis evoked by sputum obtained from patients with established COPD.
Design: Sputum supernatant of 20 patients with COPD was used as chemoattractant in a 96-well
chemotaxis chamber, with subsequent quantification of migrated cells by a luminescence assay.
The contribution of IL-8 and LTB4 to chemotaxis was determined by addition of a neutralizing
antibody and a selective receptor antagonist, respectively.
Measurements and results: COPD sputum caused neutrophil chemotaxis in a concentration dependent manner, with a maximum response evoked with a 10-fold dilution of the original
sample. Pretreatment of sputum or neutrophils with either an anti–IL-8 antibody or the LTB4
antagonist, SB 201146, led to a concentration-dependent inhibition of sputum-induced neutrophil chemotaxis, with a maximum suppression (mean SEM) of 29.2 4.9% (p < 0.001) from baseline by 100 ng/mL of anti–IL-8 antibody, and 45.6 7% (p < 0.02) by 10 mol/L of SB
201146. The combination of the anti–IL-8 antibody and SB 201146 inhibited neutrophil
chemotaxis, but this was not significantly greater than the effect of SB 201146 or anti–IL-8 alone.
Conclusions: These data confirm the importance of IL-8 and LTB4 as chemoattractants for
neutrophils in bronchial secretions from patients with COPD, and suggest that specific inhibitors
may have therapeutic potential in COPD.