[Synergistic effects of combined therapy of inhalational glucocorticosteroids with long-acting beta 2-receptor agonists in treatment of bronchial asthma].
BACKGROUND
Due to the potent anti-inflammatory strength, glucocorticosteroids are the basis of long-term (controller) therapy in asthma. They inhibit transcription of pro-inflammatory cytokines and block humoral as well as cellular derived inflammation in the bronchi. beta 2 sympathomimetics are well known to cause dilatation of the bronchi but also to modulate certain anti-inflammatory responses.
Just recently it could be demonstrated that beta 2 agonists may also be able to activate glucocorticosteroid receptors, independently of existing glucocorticosteroids. Thus, beta 2 agonists lead to augmentation of glucocorticosteroid receptor concentration, and consequently cause better efficacy of glucocorticosteroids within the cell. Vice versa glucocorticosteroids enhance the transcription rate of beta 2 receptors, causing higher beta 2 receptor number, and thus may contribute to better beta 2 agonist efficacy. These synergies of beta 2 agonists and glucocorticosteroids on molecular level explain additive efficiency in the therapy of asthma--particularly through improving lung function--when using both substances in combination.
Gillissen
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Robert-Koch-Klinik, Städtisches Klinikum St. Georg, Leipzig. adrian.gillissen@sanktgeorg.de
Welte
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T
D000280:Administration, Inhalation; D000287:Administration, Topical; D000318:Adrenergic beta-Agonists / Q000008:administration & dosage*; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage*; D001249:Asthma / Q000188:drug therapy* / Q000276:immunology; D003692:Delayed-Action Preparations; D004357:Drug Synergism; D004359:Drug Therapy, Combination; D005938:Glucocorticoids; D006801:Humans; D018836:Inflammation Mediators / Q000037:antagonists & inhibitors / Q000378:metabolism; D016896:Treatment Outcome
D000318:Adrenergic beta-Agonists; D000893:Anti-Inflammatory Agents; D003692:Delayed-Action Preparations; D005938:Glucocorticoids; D018836:Inflammation Mediators
Synergistische Effekte einer Kombinationstherapie von inhalativen Glucocorticosteroiden mit lang wirkenden beta 2-Rezeptoragonisten in der Behandlung des Asthma bronchiale.