RT Journal Article
SR Electronic
T1 Skin sensitivity to corticosteroids is associated with COPD susceptibility
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP p3360
VO 38
IS Suppl 55
A1 S.J.M. Hoonhorst
A1 A.T. Lo Tam Loi
A1 R.G.A. Hiltermann
A1 L. Koenderman
A1 J.W. Lammers
A1 D.S. Postma
A1 N.H.T. ten Hacken
YR 2011
UL http://erj.ersjournals.com/content/38/Suppl_55/p3360.abstract
AB Introduction: Inhaled corticosteroids (ICS) improve symptoms, exacerbation rates and quality of life in COPD. However, not all COPD patients benefit from ICS treatment. Corticosteroid sensitivity can be tested with the skin blanching test, where topical corticosteroids cause local vasoconstriction. We investigated in young and old individuals if skin response to corticosteroids is associated with susceptibility to develop COPD.Methods: Young (18 – 40 years) healthy subjects who were non-susceptible or susceptible to develop COPD (n=9 and 14 resp.), and older (40-75 years) subjects without and with COPD (n=15 and 47 resp.) were included. Susceptibility in young subjects was based on a high prevalence of COPD in smoking family members of these subjects. Budesonide dissolved in 95% ethanol was applied to the skin in eight concentrations (0-1000 μg/ml). Blanching was scored with a 7-point scale: 0-3 (0 = no blanching and 3 = intense blanching).Results: Young non-susceptible subjects showed higher blanching scores compared to all groups (figure 1, left). In COPD patients, a lower blanching score correlated with lower FEV1/FVC ratio (B=0.017, p<0.01) and higher GOLD stage (figure 1, right).Figure 1Conclusion: These preliminary data suggest that relative corticosteroid insensitivity contributes to COPD development and progression.