Inhaled corticosteroids in COPD - Author's reply (1)

AUTHORS’ REPLY We would like to thank Dr Tsang for his interesting comment. We appreciate his finding of a similar effect of inhaled corticosteroids both on cells and inflammatory mediators in a group of patients with bronchiectasis without any parallel changes in SaO2 or lung function indices. We agree with Dr Tsang on the necessity of long term trials with a sufficient number of subjects to show any beneficial effect of inhaled corticosteroids on inflammatory airway diseases other than asthma. In fact, as mentioned in our paper, Stanescu et al1 showed that airway obstruction as well as accelerated decline in lung function are associated with increased numbers of neutrophils in the sputum. This suggests that a reduction in airway inflammation (neutrophils) might influence the decline in lung function only over a long period of time. Further research on the effect of corticosteroids on airway inflammation could also clarify the similarities and differences in distinct airway diseases with fixed obstruction.