scholarly journals Peculiarities of mucociliary system functioning in patients with chronic obstructive pulmonary disease during treatment with tiotropium bromide

2009 ◽  
pp. 67-72
Author(s):  
D. E. Surnin ◽  
A. N. Odireev ◽  
V. P. Kolosov ◽  
A. V. Kolosov
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Stage Ii ◽  
Tiotropium Bromide ◽  
Chronic Obstructive ◽  
Ciliary Activity ◽  
Obstructive Pulmonary Disease ◽  
Mucociliary System ◽  
Integral Rate ◽  
Bronchial Mucus

Functioning of mucociliary system (MCS) including integral rate of tracheobronchial mucociliary clearance (MCC) using dynamic perfusion-lung scanning, ciliary activity in bronchial biopsy specimens and viscous and elastic properties of bronchial mucus was studied in 128 patients with chronic obstructive pulmonary disease (COPD). Of them, 90 % had mucociliary insufficiency (MCI), the intensity of which was in direct proportion to the disease severity. Development of MCI was caused by decrease in ciliary beat frequency, increased viscosity of bronchial mucus and active inflammation identified during bronchoscopy. While considered correlations between these parameters and integral rate of MCC, a method for detection of MCI has been proposed based on the solution of a discriminant equation; this method allows diagnosing MCI with 81 % of probability. Changes of MCC rate were investigated in a 6-wk prospective comparative randomized controlled trial in 69 patients with stage II COPD under different therapies according to GOLD recommendations. As a result, functional MCI was improved in 14 of 29 patients (48 %) receiving standard therapy during exacerbation and in stable condition, whereas similar improvement was reached in 28 of 40 patients (70 %) who additionally took long-acting anticholinergic drug tiotropium bromide 18 μg daily. Other 12 patients (30 %) had a weak response of MCC to tiotropium bromide due to low baseline MCC rate. A method predicting effect of tiotropium bromide on MCI in patients with stage II COPD using baseline MCC rate and a discriminant equation has been proposed.

scholarly journals The influence of basic treatment with tiotropium bromide of patients with chronic obstructive pulmonary disease stage II on the morpho-functional state of bronchial mucosa and the level of type IV collagen in bronchoalveolar lavage fluid.

2018 ◽  
Vol 25 (4) ◽  
Author(s):  
Mykola Osyrovskyy ◽  
Mariana Olegivna Kulynych-Miskiv ◽  
Iryna Savelikhina ◽  
Valentina Goncharuk ◽  
Ksenia Ostrovska
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Connective Tissue ◽  
Pulmonary Disease ◽  
Bronchoalveolar Lavage Fluid ◽  
Lavage Fluid ◽  
Stage Ii ◽  
Tiotropium Bromide ◽  
Chronic Obstructive ◽  
Bronchial Mucosa ◽  
Obstructive Pulmonary Disease

The objective of the research was to evaluate the influence of basic treatment of patients with chronic obstructive pulmonary disease with tiotropium bromide on the processes of morphological rearrangement and local barrier defence mechanisms in the bronchial mucosa.          Stage II chronic obstructive pulmonary disease is associated with the damage to the bronchi with proliferation of the connective tissue in its proper plate, clear identification of the basal membrane alteration, the presence of fibroblasts, the activation of fibroblasts/myofibroblasts and mucous glands, which is accompanied by the significant increase of type ІV collagen levels by 6.19 times (p<0.05) in bronchoalveolar lavage fluid as compared to the control group indices.          The elimination of stage II chronic obstructive pulmonary disease exacerbation and the use of tiotropium bromide within a month was accompanied only by partial improvement of morpho-functional state in relation to both cells of bronchial epithelial lining and adjacent connective tissue of mucosal plate. The prolongation of tiotropium bromide administration from 2 to 6 months, provided positive dynamics of structural morphological changes of the bronchial mucosa (the restoration of the ciliary apparatus of epithelial cells, the normalization of the secretory function of goblet cells, the inactivation of fibroblasts, the initial degeneration of myofibroblasts), thus leading to complete absence of morphological signs of edema or epithelial cell dystrophy.          Conclusions. In patients with stage II chronic obstructive pulmonary disease, complete absence of morphological signs of edema or dystrophy of epithelial cells, against the background of collagenolysis in the connective tissue of the proper mucous plate of the bronchi and the highest possible decrease in the number of myofibroblasts, with near-complete levels of type IV collagen normalization in the bronchoalveolar lavage fluid, were identified only within a 6-month treatment with tiotropium bromide.

New Treatment for Chronic Obstructive Pulmonary Disease: Tiotropium Bromide

2005 ◽  
Vol 21 (3) ◽  
pp. 144-149
Author(s):  
Emily W Evans
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Clinical Outcomes ◽  
Data Extraction ◽  
Tiotropium Bromide ◽  
Chronic Obstructive ◽  
Duration Of Action ◽  
Obstructive Pulmonary Disease ◽  
Study Selection ◽  
New Treatment

Objective: To review chronic obstructive pulmonary disease (COPD) and evaluate the role of tiotropium bromide in its treatment. Data Sources: MEDLINE was searched for articles published between 1990 and June 2004 that contained the terms tiotropium and chronic obstructive pulmonary disease. Study Selection/Data Extraction: Selected studies documented clinical outcomes related to the use of tiotropium bromide and included a complete description of methods and results. These studies were examined to determine the extent of the effect of tiotropium on clinical outcomes involved in COPD. Data Synthesis: Tiotropium bromide has a long duration of action and thus can be dosed just once daily. It was found to improve lung function, reduce symptoms, improve health status, and decrease exacerbations compared with both placebo and other bronchodilator medications. Conclusions: Tiotropium appears to be a valuable addition to the current therapies available for COPD.

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