Few studies have investigated the eff ects of
corticosteroids on macrophage function specifi cally in
patients with COPD. Dexamethasone inhibited
lipopolysaccharide-induced cytokines in COPD macrophages
in most68,69,73 but not all studies.78 Budesonide and
beclometasone suppressed lipopoly saccharide-induced
production of cytokines in macrophages from people
with COPD;79,80 however, the response was variable with
some patients showing no, or poor, responses.79 Haque
and colleagues81 showed that high-dose fl uticasone
increased nuclear translocation of the glucocorticoid
receptor in macrophages from people with COPD; this
eff ect was enhanced by the addition of a long-acting β2
agonist, and low-dose fl uticasone increased translocation
only in combination with a long-acting β2 agonist. No data
was provided regarding the eff ects on cytokine production.
In one study, a macrophage phenotype in people with
COPD has been described82 that did not express any of the
established macrophage phenotypic markers, and
budesonide did not suppress lipopolysaccharide-induced
production of pro-infl ammatory cytokines in this subset.