Dissociation between systemic and pulmonary anti‐inflammatory effects of dexamethasone in humans

• DOI: 10.1111/bcp.12857
• Publication Date: 2015-12-09T16:56:53Z
• Authors: Johann Bartko; Leopold Stiebelle...; Ulla Derhaschnig; Christian Schoerg...; Michael Schwameis; Helmut Prosch; Bernd Jilma
• Keywords: Adult; Male; 0303 health sciences; Interleukin-6; Interleukin-8; Anti-Inflammatory Agents; Pneumonia; Dexamethasone; Healthy Volunteers; 3. Good health; Endotoxins; 03 medical and health sciences; C-Reactive Protein; Double-Blind Method; Humans; Clinical Trials; Female; Inflammation Mediators; Bronchoalveolar Lavage Fluid; Glucocorticoids

Aims The local pulmonary inflammatory response has a different temporal and qualitative profile compared with the systemic response. Although glucocorticoids substantially downregulate release of acute‐phase mediators, it is not clear whether they have comparable inhibitory effects in human lung compartment. Therefore, we anti‐inflammatory pure glucocorticoid agonist, dexamethasone, on bronchoalveolar lavage blood cytokine concentrations to bronchially instilled endotoxin. Methods In this randomized, double‐blind placebo‐controlled trial, 24 volunteers received dexamethasone or placebo had endotoxin into segment saline contralateral segment, followed by lavage. Results Bronchially induced Dexamethasone strongly blunted interleukin (IL) 6 C‐reactive protein release. sharp contrast, left mediators lungs virtually unchanged: levels IL‐6 were only 18% lower IL‐8 even higher placebo, although differences between treatments statistically significant ( P = 0.07 0.08, respectively). However, extravasation neutrophil migration. Conclusions present study demonstrated remarkable dissociation its protective capillary leak one hand surprisingly low other.