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This Article Full Text Full Text (PDF) All Versions of this Article: 105/1/54    most recent 90334.2008v1 Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Google Scholar Articles by Mendes, E. S. Articles by Wanner, A. PubMed PubMed Citation Articles by Mendes, E. S. Articles by Wanner, A.

Effect of an inhaled glucocorticoid on endothelial function in healthy smokers

¹Division of Pulmonary and Critical Care Medicine, Department of Medicine, Miller School of Medicine, University of Miami, Miami, Florida; and ²Department of Respiratory Medicine, Semmelweis University School of Medicine, Budapest, Hungary

Submitted 27 February 2008 ; accepted in final form 1 May 2008

Cigarette smoking is associated with attenuated endothelium-dependent vasodilation (endothelial dysfunction) in the systemic circulation, including the airway circulation. We wished to determine whether an inhaled corticosteroid could restore endothelial function in the airway of lung-healthy current smokers, ex-smokers, and nonsmokers. We measured baseline airway blood flow (aw) and aw reactivity to inhaled albuterol as an index of endothelium-dependent vasodilation and to sublingual nitroglycerin as an index of endothelium-independent vasodilation in lung-healthy current smokers, ex-smokers, and nonsmokers. Current smokers were then treated with inhaled fluticasone for 3 wk, and all measurements were repeated after fluticasone treatment and after a subsequent 3-wk fluticasone washout period. Baseline mean aw and endothelium-independent aw reactivity were similar in the three groups. Mean endothelium-dependent aw reactivity was 49.5% in nonsmokers, 42.7% in ex-smokers, and 10.8% in current smokers (P < 0.05 vs. nonsmokers). In current smokers, mean baseline aw was unchanged after fluticasone treatment, but endothelium-dependent aw reactivity significantly increased to 34.9%. aw reactivity was again blunted after fluticasone washout. Endothelial dysfunction, as assessed by vascular reactivity, can be corrected with an inhaled corticosteroid in the airway of lung-healthy current smokers. This proof of concept can serve as the basis for future clinical investigations on the effect of glucocorticoids on endothelial function in smokers.

airway blood flow; smoking