Corticosteroids: Potential  2-Agonist and Anticholinergic Interactions in Chronic Obstructive Pulmonary Disease

Johnson, Malcolm

doi:10.1513/pats.200504-040sr

Cited by 30 publications

(21 citation statements)

References 39 publications

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“…␤2-agonists and/or anticholinergic bronchodilators and corticosteroids are often used in combination in the treatment of COPD patients (Johnson, 2005). Tiotropium is a once-daily inhaled anticholinergic bronchodilator commonly used in the treatment of COPD.…”

Section: Introductionmentioning

confidence: 99%

RETRACTED: In vitro anticholinergic drugs affect CD8+ peripheral blood T-cells apoptosis in COPD

et al. 2012

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Section: Introductionmentioning

confidence: 99%

RETRACTED: In vitro anticholinergic drugs affect CD8+ peripheral blood T-cells apoptosis in COPD

et al. 2012

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“…As recommended by Global Initiative for Asthma (GINA) guideline, LABA should not be used as monotherapy in asthma, because ICS has been reported to not only suppress airway inflammation and hyperreactivity, however, it also prevent LABA induced down-regulation of β 2 AR and recover their sensitivity, thus may lead to increase of M 3 R, PLC-β 1 , and IP 3 expression as demonstrated by McGraw943. On contrary, recent studies found that steroids could decrease the expression of muscarinic receptor and PDE4 mRNA in airway smooth muscle, which may result in bronchoprotection28434445.…”

Section: Discussionmentioning

confidence: 99%

RETRACTED ARTICLE: ß2-adrenoreceptor Inverse Agonist Down-regulates Muscarine Cholinergic Subtype-3 Receptor and Its Downstream Signal Pathways in Airway Smooth Muscle Cells in vitro

Luo

Liu

Luo

et al. 2017

Sci Rep

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Mechanisms underlying β2-adrenoreceptor (β2AR) inverse agonist mediated bronchoprotectiveness remain unknown. We incubated ICI118,551, formoterol, budesonide, and formoterol plus budesonide, as well as ICI118,551 or pindolol plus formoterol, ICI118,551 plus forskolin, SQ22,536 or H89 plus formoterol in ASMCs to detect expressions of M3R, PLCβ1 and IP3. The level of M3R in the presence of 10−5 mmol/L ICI118,551 were significantly decreased at 12 h, 24 h and 48 h (P < 0.05), and at 24 h were significantly reduced in ICI118,551 with concentration of 10−5 mmol/L, 10−6 mmol/L, 10−7 mmol/L, and 10−8 mmol/L (P < 0.05). The level of IP3 in 10−5 mmol/L ICI118,551 was significantly diminished at 24 h (P < 0.01), except for that at 1 h, neither was in the level of PLCβ1. A concentration of 10−5 mmol/L ICI118,551 at 24 h showed a significant reduction of M3R level compared to formoterol (P < 0.01), budesonide (P < 0.01), and formoterol + budesonide (P < 0.05), but significant reduction of PLCβ1 and IP3 was only found between 10−5 mmol/L ICI118,551 and formoterol at 24 h, but not in the comparison of budesonide or formoterol + budesonide. Pindolol and H89 could not inhibit the formoterol-induced expression of M3R (P > 0.05), but SQ22,536 significantly antagonized the formoterol-induced M3R expression (P < 0.05). In conclusions, β2AR inverse agonist, ICI118,551, exerts similar bronchoprotective effects to corticosteroids via decreasing the expression of M3R and inhibiting the production of IP3.

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“…[6][7][8][9] This combination of salmeterol and FP (SFC) has demonstrated a broad range of anti-inflammatory effects 10 that are greater than those seen with inhaled corticosteroid (ICS) monotherapy 11 and the likely explanation for this is a molecular interaction (synergy) between the LABA and ICS. 12 The anti-inflammatory and bronchodilator effects of SFC provides greater symptom control, pulmonary function improvement and exacerbation reduction compared with either of the individual component treatments. 9 Current COPD guidelines recommend that long acting bronchodilators should be used in patients who are symptomatic despite therapy with short acting bronchodilators.…”

mentioning

confidence: 99%

Superiority of "triple" therapy with salmeterol/fluticasone propionate and tiotropium bromide versus individual components in moderate to severe COPD

Singh

Brooks

Hagan

et al. 2008

Thorax

166

108

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Background: The combination of salmeterol and fluticasone propionate (SFC) and tiotropium bromide (TIO) are commonly used treatments in chronic obstructive pulmonary disease (COPD) but there are few data on their effectiveness when used together. We compared the effects of SFC 50/500 mg twice daily in addition to TIO 18 mg once daily with the individual treatments alone. Methods: 41 patients with COPD participated in a randomised, double blind, double dummy, three way crossover study with 2 week washout periods between treatments. Lung function assessment included plethysmography and spirometry. The primary end point was post-dose specific airways conductance (sGaw) area under the curve (AUC 0-4 h ) on day 14. Results: AUC 0-4 h sGaw was significantly higher on day 14 after SFC+TIO compared with TIO (22%) or SFC alone (27%) (both p,0.001). SFC+TIO significantly improved trough forced expiratory volume in 1 s compared with TIO alone (212 ml, p,0.001) and SFC alone (110 ml, p = 0.017) on day 14. Inspiratory capacity measurements also showed significant benefits for triple therapy over individual components on day 14. Subjects receiving SFC+TIO had clinically relevant improvements in Transition Dyspnoea Index (TDI) total score of 2.2 compared with TIO alone (p,0.001) (but not SFC alone, 0.7; NS) and used significantly less rescue medication (1.0 occasion less daily than TIO (p,0.001) and 0.6 less than SFC (p = 0.01)). Conclusion: SFC+TIO triple therapy led to greater improvements in bronchodilation compared with TIO and SFC alone. The advantages of triple therapy are observed across a range of physiologically important parameters, including airway conductance and lung volumes. Triple therapy also led to patient related benefits by improving TDI and use of rescue medication. Trial registration number: NCT00325169.Chronic obstructive pulmonary disease (COPD) is a multi-component disease with inflammation playing a key role, even in the early stages. 1 It is characterised by airflow obstruction that is both progressive and poorly reversible. 2 Drug treatments for COPD aim to control symptoms, maximise pulmonary function and reduce exacerbation rates. 2 The inhaled anticholinergic tiotropium (TIO) provides effective bronchodilation over 24 h and reduces symptoms. 3 4 These effects are associated with a reduction in exacerbation rates. 5 The long acting beta agonist (LABA) salmeterol is an alternative inhaled bronchodilator therapy and is often prescribed in a combination inhaler with the anti-inflammatory corticosteroid fluticasone propionate (FP). [6][7][8][9] This combination of salmeterol and FP (SFC) has demonstrated a broad range of anti-inflammatory effects 10 that are greater than those seen with inhaled corticosteroid (ICS) monotherapy 11 and the likely explanation for this is a molecular interaction (synergy) between the LABA and ICS. 12 The anti-inflammatory and bronchodilator effects of SFC provides greater symptom control, pulmonary function improvement and exacerbation reduction compared with eith...

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Corticosteroids: Potential 2-Agonist and Anticholinergic Interactions in Chronic Obstructive Pulmonary Disease

Cited by 30 publications

References 39 publications

RETRACTED: In vitro anticholinergic drugs affect CD8+ peripheral blood T-cells apoptosis in COPD

RETRACTED: In vitro anticholinergic drugs affect CD8+ peripheral blood T-cells apoptosis in COPD

RETRACTED ARTICLE: ß2-adrenoreceptor Inverse Agonist Down-regulates Muscarine Cholinergic Subtype-3 Receptor and Its Downstream Signal Pathways in Airway Smooth Muscle Cells in vitro

Superiority of "triple" therapy with salmeterol/fluticasone propionate and tiotropium bromide versus individual components in moderate to severe COPD

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