pulmoПульмонологияPULMONOLOGIYA0869-01892541-9617Scientific and Practical Journal “PULMONOLOGIYA” LLC10.18093/0869-0189-2010-5-101-109pulmo-1704Research ArticleСтатьиИнгаляционные глюкокортикостероиды и риск развития
пневмонии у больных хронической обструктивной
болезнью легкихАвдеевС. Н.noemail@neicon.ruБаймакановаГ. Е.noemail@neicon.ruФГУ "НИИ пульмонологии ФМБА России"Russian Federation20102810201005101109Copyright © Авдеев С.Н., Баймаканова Г.Е., 20102010Авдеев С.Н., Баймаканова Г.Е.Авдеев С.Н., Баймаканова Г.Е.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://journal.pulmonology.ru/pulm/article/view/1704хроническая обструктивная болезнь легкихингаляционные глюкокортикостероидывнебольничная пневмонияReferencesMurray C.J.L., Lopez A.D. Mortality by cause for eight regions of the world: global burden of disease study. Lancet 1997; 349: 1269-1276.Murray C.J.L., Lopez A.D. Mortality by cause for eight regions of the world: global burden of disease study. Lancet 1997; 349: 1269-1276.Buist A.S., McBurnie M.A., Vollmer W.M. et al. International variation in the prevalence of COPD (the BOLD Study): a populationbased prevalence study. Lancet 2007; 370: 741-750.Buist A.S., McBurnie M.A., Vollmer W.M. et al. International variation in the prevalence of COPD (the BOLD Study): a populationbased prevalence study. Lancet 2007; 370: 741-750.Menezes A.M., Perez+Padilla R., Jardim J.R. et al. Chronic obstructive pulmonary disease in five Latin American cities (the PLATINO study): a prevalence study. Lancet 2005; 366: 1875-1881.Menezes A.M., Perez+Padilla R., Jardim J.R. et al. Chronic obstructive pulmonary disease in five Latin American cities (the PLATINO study): a prevalence study. Lancet 2005; 366: 1875-1881.Raherison C., Girodet P.+O. Epidemiology of COPD. Eur. Respir. Rev. 2009; 18: 114, 213-221.Raherison C., Girodet P.+O. Epidemiology of COPD. Eur. Respir. Rev. 2009; 18: 114, 213-221.Ewig S. Communityacquired pneumonia. Epidemiology, risk, and prognosis. Eur. Respir. Mon. 1997; 3: 13-35.Ewig S. Communityacquired pneumonia. Epidemiology, risk, and prognosis. Eur. Respir. Mon. 1997; 3: 13-35.Armstrong G.L., Conn L.A., Pinner R.W. Trends in infectious disease mortality in the United States during the 20th cen tury. J.A.M.A. 1999; 281: 61-66.Armstrong G.L., Conn L.A., Pinner R.W. Trends in infectious disease mortality in the United States during the 20th cen tury. J.A.M.A. 1999; 281: 61-66.Kaplan V., Angus D.C., Griffin M.F. et al. Hospitalized com munity-acquired pneumonia in the elderly: age- and sex related patterns of care and outcome in the United States. Am. J. Respir. Crit. Care Med. 2002; 165: 766-772.Kaplan V., Angus D.C., Griffin M.F. et al. Hospitalized com munity-acquired pneumonia in the elderly: age- and sex related patterns of care and outcome in the United States. Am. J. Respir. Crit. Care Med. 2002; 165: 766-772.Almirall J., Mesalles E., Klamburg J. et al. Prognostic factors of pneumonia requiring admission to the intensive care unit. Chest 1995; 107: 511-516.Almirall J., Mesalles E., Klamburg J. et al. Prognostic factors of pneumonia requiring admission to the intensive care unit. Chest 1995; 107: 511-516.Ruiz M., Ewig S., Torres A. et al. Severe community- acquired pneumonia. Risk factors and followup epidemiology. Am. J. Respir. Crit. Care Med. 1999; 160: 923-929.Ruiz M., Ewig S., Torres A. et al. Severe community- acquired pneumonia. Risk factors and followup epidemiology. Am. J. Respir. Crit. Care Med. 1999; 160: 923-929.Georges H., Leroy O., Vandenbussche C. et al. Epidemio logical features and prognosis of severe community acquired pneumococcal pneumonia. Intens. Care Med. 1999; 25: 198-206.Georges H., Leroy O., Vandenbussche C. et al. Epidemio logical features and prognosis of severe community acquired pneumococcal pneumonia. Intens. Care Med. 1999; 25: 198-206.Rello J., Catalán M., Díaz E. et al. Associations between empirical antimicrobial therapy at the hospital and mortali ty in patients with severe community-acquired pneumonia. Intens. Care Med. 2002; 28: 1030-1035.Rello J., Catalán M., Díaz E. et al. Associations between empirical antimicrobial therapy at the hospital and mortali ty in patients with severe community-acquired pneumonia. Intens. Care Med. 2002; 28: 1030-1035.Rello J., Bodi M., Mariscal D. et al. Microbiological testing and outcome of patients with severe communityacquired pneumonia. Chest 2003; 123: 174-180.Rello J., Bodi M., Mariscal D. et al. Microbiological testing and outcome of patients with severe communityacquired pneumonia. Chest 2003; 123: 174-180.Ruiz de On~a J.M., Gómez M., Celdrán J., Puente+Maestu L. Neumonia en el paciente con enfermedad bstructi obstructiva cronica. Niveles de gravedad y clases de riesgo. Arch. Bronconeumol. 2003; 39: 101-105.Ruiz de On~a J.M., Gómez M., Celdrán J., Puente+Maestu L. Neumonia en el paciente con enfermedad bstructi obstructiva cronica. Niveles de gravedad y clases de riesgo. Arch. Bronconeumol. 2003; 39: 101-105.Restrepo M.I., Mortensen E.M., Pugh J.A., Anzueto A. COPD is associated with increased mortality in patients with co munityacquired pneumonia. Eur. Respir. J. 2006; 28: 346-351.Restrepo M.I., Mortensen E.M., Pugh J.A., Anzueto A. COPD is associated with increased mortality in patients with co munityacquired pneumonia. Eur. Respir. J. 2006; 28: 346-351.Rello J., Rodriguez A., Torres A. et al. Implications of COPD in patients admitted to the intensive care unit by communi ty-acquired pneumonia. Eur. Respir. J. 2006; 27: 1210-1216.Rello J., Rodriguez A., Torres A. et al. Implications of COPD in patients admitted to the intensive care unit by communi ty-acquired pneumonia. Eur. Respir. J. 2006; 27: 1210-1216.Solé+Violán J., de Castro F., García+Laorden M.I. et al. Genetic variability in the severity and outcome of commu nity-acquired pneumonia. Respir. Med. 2010; 104: 440-447.Solé+Violán J., de Castro F., García+Laorden M.I. et al. Genetic variability in the severity and outcome of commu nity-acquired pneumonia. Respir. Med. 2010; 104: 440-447.Garcia+Vidal C., Ardanuy C., Tubau F. et al. Pneumococcal pneumonia presenting with septic shock: host- and pathogen-related factors and outcomes. Thorax 2010; 65: 77-81.Garcia+Vidal C., Ardanuy C., Tubau F. et al. Pneumococcal pneumonia presenting with septic shock: host- and pathogen-related factors and outcomes. Thorax 2010; 65: 77-81.Merino+Sánchez M., Alfageme+Michavila I., Lima+Alvarez J. Prognosis in patients with pneumonia and chronic obstructive pulmonary disease. Arch. Bronconeumol. 2005; 41: 607-611.Merino+Sánchez M., Alfageme+Michavila I., Lima+Alvarez J. Prognosis in patients with pneumonia and chronic obstructive pulmonary disease. Arch. Bronconeumol. 2005; 41: 607-611.Баймаканова Г.Е., Зубаирова П.А., Авдеев С.Н., Чучалин А.Г. Особенности клинической картины и течения внебольничной пневмонии у пациентов с хронической обструктивной болезнью легких. Пульмонология 2009; 2: 33-41.Баймаканова Г.Е., Зубаирова П.А., Авдеев С.Н., Чучалин А.Г. Особенности клинической картины и течения внебольничной пневмонии у пациентов с хронической обструктивной болезнью легких. Пульмонология 2009; 2: 33-41.Boersma W.G., Sportel J.H., Lowenberg A., Koeter G.H. High prevalence of obstructive airways disease in hospitalized patients with communityacquired pneumonia: comparison of four etiologies. Clin. Pulm. Med. 2005; 12: 291-296.Boersma W.G., Sportel J.H., Lowenberg A., Koeter G.H. High prevalence of obstructive airways disease in hospitalized patients with communityacquired pneumonia: comparison of four etiologies. Clin. Pulm. Med. 2005; 12: 291-296.Mannino D.M., Davis K.J., Kiri V.A. Chronic obstructive pulmonary disease and hospitalizations for pneumonia in a US cohort. Respir. Med. 2009; 103: 224-229.Mannino D.M., Davis K.J., Kiri V.A. Chronic obstructive pulmonary disease and hospitalizations for pneumonia in a US cohort. Respir. Med. 2009; 103: 224-229.Marcy T.W., Merril W.W. Cigarette smoking and respirato ry tract infection. Clin. Chest Med. 1987; 8: 381-391.Marcy T.W., Merril W.W. Cigarette smoking and respirato ry tract infection. Clin. Chest Med. 1987; 8: 381-391.McCusker K. Mechanisms of respiratory tissue injury from cigarette smoking. Am. J. Med. 1992; 93 (suppl. 1A): 18S-21S.McCusker K. Mechanisms of respiratory tissue injury from cigarette smoking. Am. J. Med. 1992; 93 (suppl. 1A): 18S-21S.Sherman C.B. The health consequences of cigarette smok ing: pulmonary diseases. Med. Clin. North Am. 1992; 76: 355-375.Sherman C.B. The health consequences of cigarette smok ing: pulmonary diseases. Med. Clin. North Am. 1992; 76: 355-375.Almirall J., Gonzalez C.A., Balanzo X. et al. Proportion of communityacquired pneumonia cases attributable to tobacco smoking. Chest 1999; 116: 375-379.Almirall J., Gonzalez C.A., Balanzo X. et al. Proportion of communityacquired pneumonia cases attributable to tobacco smoking. Chest 1999; 116: 375-379.Crim C., Calverley P.M., Anderson J.A. et al. Pneumonia risk in COPD patients receiving inhaled corticosteroids alone or in combination: TORCH study results. Eur. Respir. J. 2009; 34: 641-647.Crim C., Calverley P.M., Anderson J.A. et al. Pneumonia risk in COPD patients receiving inhaled corticosteroids alone or in combination: TORCH study results. Eur. Respir. J. 2009; 34: 641-647.Sin D.D., Tashkin D., Zhang X. et al. Budesonide and the risk of pneumonia: a meta-analysis of individual patient data. Lancet 2009; 374: 712-719.Sin D.D., Tashkin D., Zhang X. et al. Budesonide and the risk of pneumonia: a meta-analysis of individual patient data. Lancet 2009; 374: 712-719.Lange P., Vestbo J., Nyboe J. Risk factors for death and hos pitalization from pneumonia. A prospective study of a gen eral population. Eur. Respir. J. 1995; 8: 1694-1698.Lange P., Vestbo J., Nyboe J. Risk factors for death and hos pitalization from pneumonia. A prospective study of a gen eral population. Eur. Respir. J. 1995; 8: 1694-1698.Gau J.T., Acharya U., Khan S. et al. Pharmacotherapy and the risk for communityacquired pneumonia. BMC Geriatr. 2010; 10: 45.Gau J.T., Acharya U., Khan S. et al. Pharmacotherapy and the risk for communityacquired pneumonia. BMC Geriatr. 2010; 10: 45.Almirall J., Bolíbar I., Serra+Prat M. et al. Inhaled drugs as risk factors for communityacquired pneumonia. Eur. Respir. J. 2010; Jun. 4. [Epub ahead of print].Almirall J., Bolíbar I., Serra+Prat M. et al. Inhaled drugs as risk factors for communityacquired pneumonia. Eur. Respir. J. 2010; Jun. 4. [Epub ahead of print].Calverley P.M., Anderson J.A., Celli B. et al. Salmeterol and fluticasone propionate and survival in chronic obstructive pulmonary disease. N. Engl. J. Med. 2007; 356: 775-789.Calverley P.M., Anderson J.A., Celli B. et al. Salmeterol and fluticasone propionate and survival in chronic obstructive pulmonary disease. N. Engl. J. Med. 2007; 356: 775-789.Kardos P., Wencker M., Glaab T., Vogelmeier C. Impact of salmeterol / fluticasone propionate versus salmeterol on exacerbations in severe chronic obstructive pulmonary disease. Am. J. Respir. Crit. Care Med. 2007; 175: 144-149.Kardos P., Wencker M., Glaab T., Vogelmeier C. Impact of salmeterol / fluticasone propionate versus salmeterol on exacerbations in severe chronic obstructive pulmonary disease. Am. J. Respir. Crit. Care Med. 2007; 175: 144-149.Wedzicha J.A., Calverley P.M.A., Seemungal T.A. et al. for the INSPIRE Investigators. The prevention of chronic obstructive pulmonary disease exacerbations by salmeterol / fluticasone propionate or tiotropium bromide. Am. J. Respir. Crit. Care Med. 2008; 177: 19-26.Wedzicha J.A., Calverley P.M.A., Seemungal T.A. et al. for the INSPIRE Investigators. The prevention of chronic obstructive pulmonary disease exacerbations by salmeterol / fluticasone propionate or tiotropium bromide. Am. J. Respir. Crit. Care Med. 2008; 177: 19-26.Ferguson G.T., Anzueto A., Fei R. et al. Effect of fluticasone propionate / salmeterol (250 / 50 mg) or salmeterol (50 mg) on COPD exacerbations. Respir. Med. 2008; 102: 1099-1108.Ferguson G.T., Anzueto A., Fei R. et al. Effect of fluticasone propionate / salmeterol (250 / 50 mg) or salmeterol (50 mg) on COPD exacerbations. Respir. Med. 2008; 102: 1099-1108.Anzueto A., Ferguson G.T., Feldman G. et al. Effect of fluti casone propionate / salmeterol (250 / 50) on COPD exacer- bations and impact on patient outcomes. COPD 2009; 6: 320-329.Anzueto A., Ferguson G.T., Feldman G. et al. Effect of fluti casone propionate / salmeterol (250 / 50) on COPD exacer- bations and impact on patient outcomes. COPD 2009; 6: 320-329.Metlay J.P., Kapoor W.N., Fine M.J. Does this patient have communityacquired pneumonia? Diagnosing pneumonia by history and physical examination. J.A.M.A. 1997; 278: 1440-1445.Metlay J.P., Kapoor W.N., Fine M.J. Does this patient have communityacquired pneumonia? Diagnosing pneumonia by history and physical examination. J.A.M.A. 1997; 278: 1440-1445.Ernst P., Gonzalez A.V., Brassard P., Suissa S. Inhaled corti costeroid use in chronic obstructive pulmonary disease and the risk of hospitalization for pneumonia. Am. J. Respir. Crit. Care Med. 2007; 176: 162-166.Ernst P., Gonzalez A.V., Brassard P., Suissa S. Inhaled corti costeroid use in chronic obstructive pulmonary disease and the risk of hospitalization for pneumonia. Am. J. Respir. Crit. Care Med. 2007; 176: 162-166.Joo M.J., Au D.H., Fitzgibbon M.L., Lee T.A. Inhaled corticosteroids and risk of pneumonia in newly diagnosed COPD. Respir. Med. 2010; 104: 246-252.Joo M.J., Au D.H., Fitzgibbon M.L., Lee T.A. Inhaled corticosteroids and risk of pneumonia in newly diagnosed COPD. Respir. Med. 2010; 104: 246-252.GlaxoSmithKline. Assessment of incidence of pneumonia among COPD patients with or without exposure to inhaled corticosteroids in General Practice Research Database. Available from: http://www.gsk+clinicalstudyregister.com/ files/pdf/24060.pdfGlaxoSmithKline. Assessment of incidence of pneumonia among COPD patients with or without exposure to inhaled corticosteroids in General Practice Research Database. Available from: http://www.gsk+clinicalstudyregister.com/ files/pdf/24060.pdfGlaxoSmithKline. Assessment of incidence of pneumonia among COPD patients on seretide or inhaled corticos teroids in UK primary care. Available from: http://www.gsk+ clinicalstudyregister.com/files/pdf/24056.pdfGlaxoSmithKline. Assessment of incidence of pneumonia among COPD patients on seretide or inhaled corticos teroids in UK primary care. Available from: http://www.gsk+ clinicalstudyregister.com/files/pdf/24056.pdfDrummond M.B., Dasenbrook E.C., Pitz M.W. et al. Inhaled corticosteroids in patients with stable chronic obstructive pulmonary disease. A systematic review and meta-analysis. J.A.M.A. 2008; 300: 2407-2416.Drummond M.B., Dasenbrook E.C., Pitz M.W. et al. Inhaled corticosteroids in patients with stable chronic obstructive pulmonary disease. A systematic review and meta-analysis. J.A.M.A. 2008; 300: 2407-2416.Singh S., Amin A.V., Loke Y.K. Longterm use of inhaled corticosteroids and the risk of pneumonia in chronic obstructive pulmonary disease. A metaanalysis. Arch. Intern. Med. 2009; 169: 219-229.Singh S., Amin A.V., Loke Y.K. Longterm use of inhaled corticosteroids and the risk of pneumonia in chronic obstructive pulmonary disease. A metaanalysis. Arch. Intern. Med. 2009; 169: 219-229.Rodrigo G.J., Castro+Rodriguez J.A., Plaza V. Safety and effi cacy of combined long-cting β-gonists and inhaled corti-costeroids vs longacting β-gonists monotherapy for stable COPD. A systematic review. Chest 2009; 136: 1029-1038.Rodrigo G.J., Castro+Rodriguez J.A., Plaza V. Safety and effi cacy of combined long-cting β-gonists and inhaled corti-costeroids vs longacting β-gonists monotherapy for stable COPD. A systematic review. Chest 2009; 136: 1029-1038.Nannini L.J., Cates C.J., Lasserson T.J., Poole P. Combined corticosteroid and longacting betaagonist in one inhaler versus long-cting beta-gonists for chronic obstructive pul monary disease. Cochrane Database Syst. Rev. 2007; (4): CD006829.Nannini L.J., Cates C.J., Lasserson T.J., Poole P. Combined corticosteroid and longacting betaagonist in one inhaler versus long-cting beta-gonists for chronic obstructive pul monary disease. Cochrane Database Syst. Rev. 2007; (4): CD006829.Nannini L., Cates C.J., Lasserson T.J., Poole P. Combined corticosteroid and longacting betaagonist in one inhaler versus placebo for chronic obstructive pulmonary disease. Cochrane Database Syst. Rev. 2007; (4): CD003794.Nannini L., Cates C.J., Lasserson T.J., Poole P. Combined corticosteroid and longacting betaagonist in one inhaler versus placebo for chronic obstructive pulmonary disease. Cochrane Database Syst. Rev. 2007; (4): CD003794.Singh S., Loke Y.K. An overview of the benefits and draw backs of inhaled corticosteroids in chronic obstructive pul monary disease. Int. J. COPD 2010; 5: 189-195.Singh S., Loke Y.K. An overview of the benefits and draw backs of inhaled corticosteroids in chronic obstructive pul monary disease. Int. J. COPD 2010; 5: 189-195.Neupane B., Walter S.D., Krueger P. et al. Predictors of inhospital mortality and rehospitalization in older adults with community-cquired pneumonia: a prospective cohort study. BMC Geriatrics 2010, 10: 22Neupane B., Walter S.D., Krueger P. et al. Predictors of inhospital mortality and rehospitalization in older adults with community-cquired pneumonia: a prospective cohort study. BMC Geriatrics 2010, 10: 22Menendez R, Torres A, Zalacaín R, et al. Risk factors of treatment failure in community acquired pneumonia: impli-cations for disease outcome. Thorax 2004; 59: 960-965.Menendez R, Torres A, Zalacaín R, et al. Risk factors of treatment failure in community acquired pneumonia: impli-cations for disease outcome. Thorax 2004; 59: 960-965.Malo de Molina R., Mortensen E.M., Restrepo M.I. et al. Inhaled corticosteroid use is associated with lower mortality for subjects with COPD and hospitalised with pneumonia. Eur. Respir. J. 2010; 36: 751-757.Malo de Molina R., Mortensen E.M., Restrepo M.I. et al. Inhaled corticosteroid use is associated with lower mortality for subjects with COPD and hospitalised with pneumonia. Eur. Respir. J. 2010; 36: 751-757.Welte T., Suttorp N., Marre R. CAPNETZcommunity-cquired pneumonia competence network. Infection 2004; 32: 234-238.Welte T., Suttorp N., Marre R. CAPNETZcommunity-cquired pneumonia competence network. Infection 2004; 32: 234-238.Gutierrez P., Closa D., Piner R. et al. Macrophage activation in exacerbated COPD with and without community-acquired pneumonia. Eur. Respir. J. 2010; 36: 285-291.Gutierrez P., Closa D., Piner R. et al. Macrophage activation in exacerbated COPD with and without community-acquired pneumonia. Eur. Respir. J. 2010; 36: 285-291.Soler N., Ewig S., Torres A. et al. Airway inflammation and bronchial microbial patterns in patients with stable chronic obstructive pulmonary disease. Eur. Respir. J. 1999; 14: 1015-1022.Soler N., Ewig S., Torres A. et al. Airway inflammation and bronchial microbial patterns in patients with stable chronic obstructive pulmonary disease. Eur. Respir. J. 1999; 14: 1015-1022.Torres A., Menendez R. Mortality in COPD patients with communityacquired pneumonia: who is the third partner? Eur. Respir. J. 2006; 28: 262-263.Torres A., Menendez R. Mortality in COPD patients with communityacquired pneumonia: who is the third partner? Eur. Respir. J. 2006; 28: 262-263.Page J.A. Two cases of fulminating pneumonia in patients on hormone therapy. Br. Med. J. 1954; 1: 1334-35.Page J.A. Two cases of fulminating pneumonia in patients on hormone therapy. Br. Med. J. 1954; 1: 1334-35.Wolfe F., Caplan L., Michaud K. Treatment for rheumatoid arthritis and the risk of hospitalization for pneumonia asso http://www.pulmonology.ru 109 Обзоры ciations with prednisone, diseasemodifying antirheumatic drugs, and antitumor necrosis factor therapy. Arthritis Rheumatism 2006; 54: 628-634.Wolfe F., Caplan L., Michaud K. Treatment for rheumatoid arthritis and the risk of hospitalization for pneumonia asso http://www.pulmonology.ru 109 Обзоры ciations with prednisone, diseasemodifying antirheumatic drugs, and antitumor necrosis factor therapy. Arthritis Rheumatism 2006; 54: 628-634.Lipworth B.J. Systemic adverse effects of inhaled corticos teroid therapy. A systematic review and metaanalysis. Arch. Intern. Med. 1999; 159: 941-955.Lipworth B.J. Systemic adverse effects of inhaled corticos teroid therapy. A systematic review and metaanalysis. Arch. Intern. Med. 1999; 159: 941-955.Welte T. Inhaled corticosteroids in COPD and the risk of pneumonia. Lancet 2009; 374: 668-670.Welte T. Inhaled corticosteroids in COPD and the risk of pneumonia. Lancet 2009; 374: 668-670.Wedzicha J.A., Seemungal T.A. COPD exacerbations: defining their cause and prevention. Lancet 2007; 370: 786-796.Wedzicha J.A., Seemungal T.A. COPD exacerbations: defining their cause and prevention. Lancet 2007; 370: 786-796.von Baum H., Welte T., Marre R.et al. for the Capnetz Study Group. Communitycquired pneumonia through enter-obacteriaceae and Pseudomonas aeruginosa: diagnosis, incidence and predictors. Eur. Respir. J. 2010; 35: 598-615.von Baum H., Welte T., Marre R.et al. for the Capnetz Study Group. Communitycquired pneumonia through enter-obacteriaceae and Pseudomonas aeruginosa: diagnosis, incidence and predictors. Eur. Respir. J. 2010; 35: 598-615.Ko F.W.S., Ip M., Chan P.K.S. et al. A oneyear prospective study of infectious etiology in patients hospitalized with acute exacerbations of COPD and concomitant pneumonia. Respir. Med. 2008; 102: 1109-1116.Ko F.W.S., Ip M., Chan P.K.S. et al. A oneyear prospective study of infectious etiology in patients hospitalized with acute exacerbations of COPD and concomitant pneumonia. Respir. Med. 2008; 102: 1109-1116.Pifarre R., Falguera M., Vicente+de+Vera C., Nogues A. Characteristics of communityacquired pneumonia in patients with chronic obstructive pulmonary disease. Respir. Med. 2007; 101: 2139-2144.Pifarre R., Falguera M., Vicente+de+Vera C., Nogues A. Characteristics of communityacquired pneumonia in patients with chronic obstructive pulmonary disease. Respir. Med. 2007; 101: 2139-2144.Hogg J.C., Chu F.S., Tan W.C. et al. Survival after lung vol ume reduction in chronic obstructive pulmonary disease: insights from small airway pathology. Am. J. Respir. Crit. Care Med. 2007, 176: 454-459.Hogg J.C., Chu F.S., Tan W.C. et al. Survival after lung vol ume reduction in chronic obstructive pulmonary disease: insights from small airway pathology. Am. J. Respir. Crit. Care Med. 2007, 176: 454-459.Diamond G., Legarda D., Ryan L.K. The innate immune response of the respiratory epithelium. Immunol. Rev. 2000, 173: 27-38.Diamond G., Legarda D., Ryan L.K. The innate immune response of the respiratory epithelium. Immunol. Rev. 2000, 173: 27-38.MacRedmond R.E., Greene C.M., Taggart C.C. et al. Respiratory epithelial cells require Tolllike receptor 4 for induction of human betadefensin 2 by lipopolysaccharide. Respir. Res. 2005, 6: 116.MacRedmond R.E., Greene C.M., Taggart C.C. et al. Respiratory epithelial cells require Tolllike receptor 4 for induction of human betadefensin 2 by lipopolysaccharide. Respir. Res. 2005, 6: 116.MacRedmond R.E., Greene C.M., Dorscheid D.R. et al. Epithelial expression of TLR4 is modulated in COPD and by steroids, salmeterol and cigarette smoke. Respir. Res. 2007, 8: 84.MacRedmond R.E., Greene C.M., Dorscheid D.R. et al. Epithelial expression of TLR4 is modulated in COPD and by steroids, salmeterol and cigarette smoke. Respir. Res. 2007, 8: 84.Esmailpour N., Hogger P., Rohdewald P. Binding of gluco corticoids to human nasal tissue in vitro. Int. Arch. Allergy Immunol. 2000; 122: 151-154.Esmailpour N., Hogger P., Rohdewald P. Binding of gluco corticoids to human nasal tissue in vitro. Int. Arch. Allergy Immunol. 2000; 122: 151-154.Mortimer K.J., Tattersfi eld A.E., Tang Y. et al. Plasma con centrations of fl uticasone propionate and budesonide fol lowing inhalation: eff ect of induced bronchoconstriction. r. J. Clin. Pharmacol. 2007; 64: 439-444.Mortimer K.J., Tattersfi eld A.E., Tang Y. et al. Plasma con centrations of fl uticasone propionate and budesonide fol lowing inhalation: eff ect of induced bronchoconstriction. r. J. Clin. Pharmacol. 2007; 64: 439-444.Ek A., Larsson K., Siljerud S., Palmberg L. Fluticasone and budesonide inhibit cytokine release in human lung epithelial cells and alveolar macrophages. Allergy 1999; 54: 691-699.Ek A., Larsson K., Siljerud S., Palmberg L. Fluticasone and budesonide inhibit cytokine release in human lung epithelial cells and alveolar macrophages. Allergy 1999; 54: 691-699.
The authors declare that there are no conflicts of interest present.