S89 Epithelial Mesenchymal Transition (EMT) in Chronic Obstructive Pulmonary Disease (COPD) Airways is Attenuated by Inhaled Corticosteroids (ICS): Abstract S89 Table 1

Abstract

Introduction and Objectives We recently reported1, 2 that EMT is active in the airways of COPD patients; in this process epithelial cells change shape and become motile, then digest through the reticular basement membrane (Rbm) which becomes fragmented and transition to a mesenchymal fibroblast-like cell. We also demonstrated that the Rbm is hyper-vascular, a combined picture specifically suggesting active EMT-type-III, which is a dangerous, pre-malignant condition. This may well be the link between COPD and lung cancer. In this study, we have assessed the effects of ICS on markers of EMT in endobronchial biopsies (ebb) in COPD. Methods A double-blinded, randomised, placebo-controlled study assessed the effects of inhaled fluticasone propionate (FP: 500μg twice daily) on EMT in 34 COPD patients. Ebb were assessed for EMT related Rbm fragmentation (core structural marker) and immunostained for the EMT signatures S100A4 (a fibroblast epitope), matrix-metalloproteinase-9 (MMP-9) and the epithelial activation marker, epidermal growth factor receptor (EGFR). (Table presented) Conclusions This is the first study to report the positive effects of ICS on EMT markers in COPD. This may be the mechanistic link between ICS and its reported preventive action against smoking-related lung cancer in COPD.