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Inflammation and Treatment in Asthma and COPD

By James F. Donohue, MD, FCCP; and Jill A. Ohar, MD, FCCP

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Asthma

Table 1—Characteristics of Inflammation in COPD and Asthma*
  COPD Asthma
Cells Neutrophils Eosinophils
Large increase in macrophages Small increase in macrophages
Increase in CD8+ T lymphocytes Increase in CD4+ Th2 lymphocytes
Activation of mast cells
Mediators LTB4 Leukotriene D4
IL-8 IL-4, IL-5
TNF-a (And many others)
Consequences Squamous metaplasia of epithelium Fragile epithelium
Parenchymal destruction Thickening of basement membrane
Mucus metaplasia Mucus metaplasia
Glandular enlargement Glandular enlargement
Response to treatment Glucocorticosteroids have little or no effect Glucocorticosteroids inhibit inflammation
*Reprinted from the GOLD guidelines (www.goldcopd.com).

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