Interpreting the significance of collagen-IV level changes in bronchoalveolar fluid in acute COPD exacerbation before and after tiotropium bromide treatment

Background & objectives. Chronic obstructive pulmonary disease (COPD) is a common chronic respiratory condition resulting in gradual deterioration and worsening of symptoms. The anticholinergic agent tiotropium bromide is a long-acting bronchodilator targeted at COPD. Objective: To investigate the dynamics of the collagen-IV levels in bronchoalveolar lavage (BAL) with once-daily use of tiotropium bromide for the treatment of COPD GOLD II. Methods: The BAL collagen-IV levels of 60 COPD GOLD II patients were investigated before and on days 30 and 60 of therapy using conventional treatment regimens and inhalations of tiotropium bromide at the recommended dose of 18 mcg once a day. The collagen-IV levels in BALF were determined by enzyme-linked immunosorbent assay. The control group consisted of 15 apparently healthy people (AHP). Results: Verification of COPD GOLD II, as compared with AHP, is accompanied by increase in collagen-IV level (6.15 times, p<0.05) in BAL. The once-daily inhalation of tiotropium bromide as the maintenance therapy of COPD patients provides a significant reduction of collagen-IV levels in BAL, which depends on the duration of tiotropium use. Conclusions: The obtained findings indicate the effect of tiotropium bromide on reduce of collagen-IV levels, especially of long term drug use.