Clinical effects of lentinan combined with budesonide inhalation in treating acute exacerbation of chronic obstructive pulmonary disease under mechanical ventilation

Authors: Jian Sun and Gang Zhao

Journal: Experimental and Therapeutic Medicine

Study Design: Randomized, double-blind clinical trial

Participants: 72 cases of severe acute exacerbation of chronic obstructive pulmonary disease (AECOPD) admitted to the ICU with the requirement of ventilator support

Intervention: The AECOPD patients were randomly divided into two groups:

• Experimental group (n=36): Received oral administration of 0.5 g lentinan twice/day and inhalation of 2 ml budesonide (0.5 mg/ml) twice a day over 4 days delivered by a breathing machine Y-tube
• Control group (n=36): Received only budesonide atomization inhalation (bid over 4 days) via a breathing machine Y-tube.

All patients received the same antibiotic therapy (cephalosporins).

Outcome Measures:

• Airway pressure of breathing machine
• Mechanical ventilation time
• Length of ICU stay
• Plasma levels of adiponectin (APN), D-dimer (D-D), serum IL-17 and hs-CRP
• Proportions of CD3+, CD4+ and CD8+ T‐cells

Summary: The study aimed to assess the clinical efficacy of the immune modulator lentinan combined with inhalation of the corticosteroid budesonide in treating acute exacerbation of chronic obstructive pulmonary disease (AECOPD) under mechanical ventilation. The results indicated that the airway pressure, the time of mechanical ventilation and the time of stay at the intensive care unit for the experimental group were significantly lower than those for the control group. The plasma levels of adiponectin, D-dimer, interleukin-17 and high-sensitivity C-reactive protein, as well as the pressure of CO2 in the experimental group were significantly lower than those in the control group. Furthermore, the partial O2 pressure in the experimental group was significantly higher than that in the control group. After the combined treatment, the proportions of CD3+ and CD4+ T-cells in the blood were elevated, while the proportion of CD8+ T-cells was decreased, compared with those in the experimental group at baseline or the control group post-treatment. The study concluded that the strategy of lentinan treatment combined with budesonide inhalation for AECOPD patients under mechanical ventilation demonstrated improved clinical efficacy compared with budesonide alone.