제116 차 대한결핵 및 호흡기학회 추계학술대회 2013
Thematic Poster
TP-11
Phosphoinositide 3-kinase δ Signaling Influences Aspergillus Fumigatus-induced
Allergic Lung Inflammation by Modulating Endoplasmic Reticulum Stress
전북대학교 의학전문대학원 호흡기알레르기 내과학교실
이용철, 김소리, 이경선, 고윤희, 이양근, 이흥범, 박성주, 최영훈, 박승용, 정재석
Phosphoinositide 3-kinase (PI3K)-δ signaling and endoplasmic reticulum (ER) stress are critically involved in various inflammatory processes. In this study, we aimed to elucidate an association of ER stress with PI3K-δ signaling in fungus-induced
allergic lung inflammation. Using Aspergillus fumigatus-exposed in vivo and in vitro experimental systems, we have investigated the role of PI3K-δ in the regulation of ER stress in the pathogenesis of allergic lung inflammation. The Aspergillus
fumigatus-sensitized and -challenged mice showed that the expression of ER stress markers and the protein levels of unfolded
protein response (UPR)-related markers in lung tissues were significantly increased after Aspergillus fumigatus challenge.
Protein expression of ER stress markers was also remarkably elevated in Aspergillus fumigatus-stimulated cultured tracheal
epithelial cells. However, administration of PI3K-δ inhibitor significantly reduced the increases in ER stress markers and
UPR-related proteins in the lung. And, blockade of PI3K-δ signaling using PI3K-δ inhibitor or PI3K-δ specific siRNA
also markedly reduced the expression of ER stress markers in Aspergillus fumigatus-stimulated cultured tracheal epithelial
cells. Furthermore, inhibition of PI3K-δ or ER stress improved various pathophysiologic features in Aspergillus fumigatus-induced allergic lung inflammation. These findings suggest that PI3K-δ signaling is implicated in Aspergillus fumigatus-induced
allergic lung inflammation through the modulation of ER stress.
TP-12
The Effect of Fluticasone/Salmoterol Added to Tiotropium versus
Tiotropium about Cough or Phlegm in the Patients with COPD:
Post Hoc Analysis of the SUPER Study
1
WonKwang University Sanbon Hospital, 2Asan Medical Center, University of Ulsan College of Medicine,
3
Hallym University Sacred Heart Hospital at Pyeongchon
Jinkyeong Park1, Sang Do Lee2, Ki Suck Jung3, Yeon-Mok Oh2, Hui-Jung Kim1
The patients with chronic obstructive pulmonary disease (COPD) show various symptoms. In addition to breathlessness, cough
and phlegm are the major symptoms. Although many clinical trials revealed that breathlessness is improved by inhaled therapy
in COPD patients, the effect of these inhalers on cough or phlegm was not evaluated.The SUPER study demonstrated the
improvement in lung function of the fluticasone/salmeterol (FSC) added to tiotropium statistically superior to that of tiotropium
alone. We performed a post hoc analysis of the SUPER study with particular focus on cough and phlegm.At baseline, 89
(tiotropium +FSC vs tiotropium 22% vs 21%) patients complained that they suffered cough in most days a week. 106 (27%
vs. 25%) patients did in a few days a week. 151 (38% vs 36%) patients did in only with chest infection. 134 (tiotropium +FSC
vs tiotropium 33% vs 32%) patients complained that they suffered phlegm in most days a week. 126 (31% vs 30%) patients
did in a few days a week. 101 (25% vs 25%) patients did in only with chest infection. At the end of study, 148(40% vs 32%)
patients showed the improvement on cough, 190(43.1% vs 49.0%) patients had no change, and 74 (17% vs 19%) patients aggravated the cough. 42 (38% vs 31%) patients showed the improvement on phlegm, 76 (15% vs 22%) patients had no change,
and 194 (47% vs 48%) patients aggravated the phlegm. In the patients suffered cough in most days a week at the baseline,
tiotropium+FSC group had significantly more improvement in cough than tiotropium alone (76% vs 55%, p=0.047). There was
no effect of phlegm between groups. In COPD patients presenting with cough, tiotropium combined FSC treatment was more
helpful than tiotropium alone. However the effect of triple inhaled treatment about phlegm in COPD patients were similar
to tiotropium alone.
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