title: Can β2-adrenoceptor agonists, anticholinergic drugs, and theophylline contribute to the control of pulmonary inflammation and emphysema in COPD?
abstract: Chronic obstructive pulmonary disease (COPD) has become a global epidemic disease with an increased morbidity and mortality in the world. Inflammatory process progresses and contributes to irreversible airflow limitation. However, there is no available therapy to better control the inflammatory progression and therefore to reduce the exacerbations and mortality. Thus, the development of efficient anti-inflammatory therapies is a priority for patients with COPD. β(2) -Adrenoceptor agonists and anticholinergic agents are widely used as first line drugs in management of COPD because of their efficient bronchodilator properties. At present, many studies in vitro and some data obtained in laboratory animals reveal the potential anti-inflammatory effects of these bronchodilators but their protective role against chronic inflammation and the development of emphysema in patients with COPD remains to be investigated. The anti-inflammatory effects of theophylline at low doses have also been identified. Beneficial interactions between glucocorticoids and bronchodilators have been reported, and signaling pathways explaining these synergistic effects begin to be understood, especially for theophylline. Recent data demonstrating interactions between anticholinergics with β(2) -adrenoceptor agonists aiming to better control the pulmonary inflammation and the development of emphysema in animal models of COPD justify the priority to investigate the interactive effects of a tritherapy associating corticoids with the two main categories of bronchodilators.
authors: Department of Physiology, School of Medicine, Shanghai JiaoTong University, Shanghai, China. i_zhangwenhui@yahoo.com.cn
authors: Wen-Hui
authors: WH
authors: Zhang
authors: Yong
authors: Y
authors: Zhang
authors: Yong-Yao
authors: YY
authors: Cui
authors: Wei-Fang
authors: WF
authors: Rong
authors: Carole
authors: C
authors: Cambier
authors: Philippe
authors: P
authors: Devillier
authors: Fabrice
authors: F
authors: Bureau
authors: Charles
authors: C
authors: Advenier
authors: Pascal
authors: P
authors: Gustin
mesh_terms: D058666:Adrenergic beta-2 Receptor Agonists / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use; D000818:Animals; D001993:Bronchodilator Agents / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D018680:Cholinergic Antagonists / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use; D018450:Disease Progression; D004357:Drug Synergism; D004646:Emphysema / Q000188:drug therapy / Q000209:etiology; D006801:Humans; D007249:Inflammation / Q000188:drug therapy* / Q000209:etiology / Q000473:pathology; D029424:Pulmonary Disease, Chronic Obstructive / Q000188:drug therapy* / Q000503:physiopathology; D013806:Theophylline / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use
chemical_list: D058666:Adrenergic beta-2 Receptor Agonists; D001993:Bronchodilator Agents; D018680:Cholinergic Antagonists; D013806:Theophylline