Theophylline: potential antiinflammatory effects in nocturnal asthma.

BACKGROUND

Recent information suggests that one of the therapeutic properties of theophylline is an antiinflammatory effect.

OBJECTIVE

We evaluated this potential effect of theophylline in eight patients with nocturnal asthma.

METHODS

The study design was a randomized, double-blind, placebo-controlled crossover of 2-week treatment periods, separated by a 1-week washout period. Spirometry and bronchoscopy were performed.

RESULTS

Theophylline, compared with placebo, significantly improved the overnight decrement in lung function. The higher the nocturnal theophylline level, the greater the improvement in lung function. Theophylline also significantly decreased the percentage of neutrophils in the 4:00 AM bronchoalveolar lavage fluid and stimulated leukotriene B4 levels from macrophages obtained at 4:00 AM. The greater change in neutrophils correlated with increasing serum theophylline concentration. Also, the change in leukotriene B4 production was significantly correlated with the theophylline-induced decrement in lavage granulocytes (neutrophils and eosinophils).

CONCLUSION

This study suggests that one action of theophylline is to alter inflammatory cell number and function in nocturnal asthma and that it may do this through an leukotriene B4-mediated mechanism.