Antiinflammatory Effects of the Phosphodiesterase-4 Inhibitor Cilomilast (Ariflo) in Chronic Obstructive Pulmonary Disease

Elizabeth Gamble, Diana C. Grootendorst, Christopher E. Brightling, Susannah Troy, Yusheng Qiu, Jie Zhu, Debbie Parker, Dean Matin, Swati Majumdar, Antonio M. Vignola, Claus Kroegel, Ferran Morell, Trevor T. Hansel, Stephen I. Rennard, Christopher Compton, Ohad Amit, Tri Tat, Jeffrey Edelson, Ian D. Pavord, Klaus F. RabeNeil C. Barnes, Peter K. Jeffery

Research output: Contribution to journalArticlepeer-review

202 Scopus citations


Cilomilast (Ariflo), a new oral phosphodiesterase-4 selective inhibitor, improves lung function in chronic obstructive pulmonary disease (COPD). We have evaluated its antiinflammatory effects in 59 patients with COPD randomized to receive cilomilast, 15 mg two times a day, or placebo for 12 weeks. Induced sputum differential cell counts were obtained at baseline and at five further visits. Interleukin-8 and neutrophil elastase were measured in sputum supernatant. Bronchial biopsies obtained at baseline and at Week 10 were immunostained and counted for neutrophils, CD8+ and CD4+ T-lymphocyte subsets, and CD68+ macrophages. Cells expressing the genes for interleukin-8 and tumor necrosis factor-α were identified by in situ hybridization and quantified. Compared with placebo, analysis of variance (ANOVA) of the change from baseline showed that cilomilast did not alter any sputum endpoint or FEV 1. However, bronchial biopsies demonstrated that cilomilast treatment was associated with reductions in CD8+ (p = 0.001; ANOVA) and CD68+ cells (p < 0.05; ANOVA). In addition, by Poisson analysis, comparison of cell counts analyzed as a ratio of active to placebo demonstrated reductions of CD8+ (48% p < 0.01) and CD68+ (47% p = 0.001) cells. This is the first demonstration of reduction by any agent of airway tissue inflammatory cells characteristic of COPD. Phosphodiesterase-4 inhibitors represent a promising new class of substances for use in antiinflammatory treatment of this disease.

Original languageEnglish (US)
Pages (from-to)976-982
Number of pages7
JournalAmerican Journal of Respiratory and Critical Care Medicine
Issue number8
StatePublished - Oct 15 2003
Externally publishedYes


  • Bronchial biopsy
  • Chronic bronchitis
  • Emphysema
  • Induced sputum
  • Inflammation

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine


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