Department of Physiology and Pharmacology, Western University, London, ON, Canada.
Department of Medicine, Western University, London, ON, Canada.
Lung. 2020 Dec;198(6):909-916. doi: 10.1007/s00408-020-00399-2. Epub 2020 Oct 26.
Lung inflammation is associated with many respiratory conditions. Consequently, anti-inflammatory medications, like glucocorticoids, have become mainstay intrapulmonary therapeutics. However, their effectiveness for treating inflammation occurring in the alveolar regions of the lung is limited by suboptimal delivery. To improve the pulmonary distribution of glucocorticoids, such as budesonide to distal regions of the lung, exogenous surfactant has been proposed as an ideal delivery vehicle for such therapies. It was therefore hypothesized that fortifying an exogenous surfactant (BLES) with budesonide would enhance efficacy for treating pulmonary inflammation in vivo.
An intratracheal instillation of heat-killed bacteria was used to elicit an inflammatory response in the lungs of male and female rats. Thirty minutes after this initial instillation, either budesonide or BLES combined with budesonide was administered intratracheally. To evaluate the efficacy of surfactant delivery, various markers of inflammation were measured in the bronchoalveolar lavage and lung tissue.
Although budesonide exhibited anti-inflammatory effects when administered alone, delivery with BLES enhanced those effects by lowering the lavage neutrophil counts and myeloperoxidase activity in lung tissue. Combining budesonide with BLES was also shown to reduce several other pro-inflammatory mediators. These results were shown across both sexes, with no observed sex differences.
Based on these findings, it was concluded that exogenous surfactant can enhance the delivery and efficacy of budesonide in vivo.
肺部炎症与许多呼吸系统疾病有关。因此,抗炎药物,如糖皮质激素,已成为肺部内治疗的主要方法。然而,由于其输送效果不佳,它们在治疗肺泡区域发生的炎症方面的效果受到限制。为了改善糖皮质激素(如布地奈德)向肺部远端区域的肺部分布,外源性表面活性剂已被提议作为此类治疗的理想输送载体。因此,有人假设用布地奈德强化外源性表面活性剂(BLES)会增强其治疗体内肺部炎症的功效。
通过气管内滴注加热杀死的细菌在雄性和雌性大鼠的肺部引发炎症反应。在初次滴注 30 分钟后,通过气管内给药给予布地奈德或 BLES 联合布地奈德。为了评估表面活性剂输送的功效,在支气管肺泡灌洗液和肺组织中测量了各种炎症标志物。
尽管单独给予布地奈德具有抗炎作用,但与 BLES 联合给药通过降低灌洗液中性粒细胞计数和肺组织髓过氧化物酶活性增强了这些作用。将布地奈德与 BLES 联合使用还显示可降低其他几种促炎介质。这些结果在两性中均有显示,且未观察到性别差异。
基于这些发现,可以得出结论,外源性表面活性剂可以增强布地奈德在体内的输送和功效。