The Effect on Small Airways of Addition of Theophylline as Inducer of Histone Deacilase Activity for Patients With Moderate to Severe Chronic Obstructive Pulmonary Disease (COPD), Treated With Inhaled Steroids and Long Acting Beta Agonists
The Effect on Small Airways of Addition of Theophylline as Inducer of Histone Deacilase Activity for Patients With Moderate to Severe Chronic Obstructive Pulmonary Disease (COPD), Treated With Inhaled Steroids and Long Acting Beta Agonists
Chronic obstructive pulmonary disease (COPD) is a chronic progressive respiratory disorder
 causing disability with an increasing burden to the patient, his family and to the health
 services. Treatment of COPD patients depends on the stage of the disease. COPD responds
 poorly to corticosteroids, in spite of inflammation is a major component in its pathogenesis.
 A major barrier to therapy of COPD is resistance to the anti-inflammatory effects of
 corticosteroids. The molecular mechanisms for this corticosteroid resistance are now being
 elucidated, particularly as the molecular basis for the anti-inflammatory effects of
 corticosteroids is better understood (12). An important mechanism of corticosteroid
 resistance in COPD, which is also linked to amplification of the inflammatory process, is a
 reduction in the critical nuclear enzyme histone deacetylase (HDAC)2 . Since the major
 changes are at the level of small airways. We will examine the effect of addition of
 theophylline product to stable COPD patients treated with combined inhaler of inhaled
 corticosteroids.
Inclusion Criteria:

 -  stable stage II and III (GOLD) COPD, diagnosed 2 years ago and up

 Exclusion Criteria:

 -  Heart failure Malignancy Immune suppressed