-Although Staphylococcus aureusis a major cause of pulmonary infection, the role played by this bacterium in the induction of inflammation of human airway epithelial cells (HAEC) is poorly understood. In this study, we investigated the inflammatory response of HAEC to S. aureus soluble virulence factors and demonstrate that the combination of a long-acting  2-adrenergic receptor agonist (salmeterol) with a glucocorticoid (fluticasone propionate) has an anti-inflammatory effect on HAEC. First, we demonstrate increased expression at both the mRNA and protein levels of interleukin (IL)-8, IL-6, and tumor necrosis factor (TNF)-␣ following incubation of HAEC in the presence of S. aureus soluble virulence factors and the increase of 1) the free nuclear factor-B (NF-B) and activator protein-1 (AP-1) activities and 2) the phosphorylated (P-) extracellular signal-regulated kinases 1 and 2 (ERK1/ERK2), the P-c-Jun NH 2-terminal kinase (JNK), and the P-isoform-␣ of the NF-B inhibitor (I B␣). Next, when HAEC were preincubated with the combination of salmeterol and fluticasone propionate, the inflammatory response of HAEC was markedly attenuated in that levels of IL-8, IL-6, TNF-␣, NF-B, AP-1, P-ERK1/ERK2, P-JNK, and P-I B␣ decreased significantly. These data emphasize the deleterious effect of S. aureus soluble virulence factors and suggest that the combination of a 2-adrenergic receptor agonist with a glucocorticoid may attenuate the associated airway epithelial inflammation. airway inflammation; proinflammatory cytokines; nuclear fator-B and activator protein-1 activation; glucocorticoid; bacterial virulence factors STAPHYLOCOCCUS AUREUS is one of the most common grampositive bacterial pathogens, involved in airway infections, either primary or subsequent to viral diseases (17). S. aureus is also a major cause of hospital-acquired lower respiratory tract infections and is often implicated in early infectious airway disease in cystic fibrosis patients (2, 5, 6, 22). S. aureus expresses several potential virulence factors (VF) that may induce airway epithelial injury, inactivate host defense mechanisms, and impair the epithelial wound/repair process. The increasing emergence of methicillin-resistant S. aureus requires a better understanding of staphylococcal pathogenesis in infectious and inflammatory airway diseases. S. aureus surface proteins such as adhesins and protein A are produced during exponential growth phase, whereas most exoproteins, including toxins, hemolysins, and tissue-degrading enzymes, are secreted during the stationary phase. Alpha-toxin, one of the major soluble VF of S. aureus, is able to induce transient apoptosis followed by the necrosis of human airway epithelial cells (HAEC) (9). We have also recently shown that live S. aureus and more predominantly soluble VF in contact with HAEC induce marked alterations in the transcriptional expression profile of HAEC associated with activation of the NF-B and activator protein (AP)-1 pathway, upregulation of PGE 2 and cyclooxygenase (COX)-2 expression and pr...