title: Effects of (r,r)- and (r,r/s,s)-formoterol on airway relaxation and contraction in an experimental rat model.
abstract: BACKGROUND
  Racemic (R,R/S,S)-formoterol is a long-acting β-agonist composed of a 50:50 mixture of (R,R)- and (S,S)-enantiomers.
  
  
  OBJECTIVE
  The aim of this study was to determine whether (R,R)-formoterol and (R,R/S,S)-formoterol have differing effects on airway contraction and relaxation in vitro.
  
  
  METHODS
  Cylindrical airway segments 3-mm long were isolated from the mid-trachea of healthy Sprague-Dawley rats and placed in a modified Krebs-Henseleit solution. Dose-response curves of bethanechol-induced contraction (measured as milligrams of tension) and the concentration of bethanechol that elicited 50% to 75% of maximal contraction (EC50-75) were determined. The air-way cylinders were then precontracted with bethanechol at the EC50-75 and exposed to different concentrations of (R,R)-formoterol (0.0001-1.0 μM) or (R,R/S,S)-formoterol (0.0002-2.0 μM). Each concentration of the 2 formoterol formulations contained the same amount of (R,R)-enantiomer (eg, [R,R]-formoterol 0.0001 μM and [R,R/S,S]-formoterol 0.0002 1JM contained the same amount of [R,R]-enantiomer). The relaxation percentage in response to formoterol was calculated as a reduction in tension (in milligrams) in relation to baseline tension in the precontracted state, with each tracheal cylinder serving as its own control. To determine the effect of (R,R)-formoterol on airway contraction, tracheal cylinders were incubated with (R,R)- or (R,R/S,S)-formoterol before electrical field stimulation (EFS).
  
  
  RESULTS
  Tracheae from 56 three-week-old Sprague-Dawley rats were used in the study. The relaxation percentage of precontracted trachea was significantly greater after exposure to (R,R)-formoterol than to (R,R/S,S)-formoterol at a 2-fold higher concentration (P = 0.03; general linear model with repeated measures analysis comparing the 2 groups of animals). However, in a post hoc analysis, the mean (SE) relaxation percentage of precontracted trachea was significantly greater only after exposure to (R,R)-formoterol 0.01 μM than to (R,R/S,S)-formoterol 0.02 μM (15.6% [5.8%] vs 39.0% [5.6%]; P < 0.05, unpaired t test). EFS-induced airway contraction was significantly less in tracheal cylinders incubated in (R,R)-formoterol compared with those incubated in (R,R/S,S)-formoterol at a 2-fold higher concentration (P = 0.05; general linear model with repeated measures analysis comparing the 2 groups of animals). However, in the post hoc analysis, mean (SE) EFS-induced tracheal contraction was significantly less only in (R,R)-formoterol 0.01 μM compared with (R,R/S,S)-formoterol 0.02 μM at 10 V (1070 [55] mgvs 1225 [28] mg; P < 0.05, unpaired t test).
  
  
  CONCLUSIONS
  We found that (R,R)-formoterol may induce greater relaxation of precontracted airway smooth muscle cells than (R,R/S,S)-formoterol and that (R,R)-formoterol may have a greater inhibitory effect on the endogenous cholinergic and excitatory nonadrenergic, noncholinergic contractile airway responses than (R,R/S,S)-formoterol. We speculate that the presence of the (S,S)-enantiomer in (R,R/S,S)-formoterol may impair airway relaxation of pre-contracted trachea in rats.
authors.affiliation: Department of Pediatrics, MetroHealth Medical Center, Case Western Reserve University, Cleveland, Ohio.
authors.forename: Maroun J
authors.initials: MJ
authors.lastname: Mhanna
authors.affiliation: Sepracor Inc., Marlborough, Massachusetts.
authors.forename: Jeffrey F
authors.initials: JF
authors.lastname: Koester
authors.affiliation: Department of Pediatrics, MetroHealth Medical Center, Case Western Reserve University, Cleveland, Ohio.
authors.forename: Robert C
authors.initials: RC
authors.lastname: Cohn
keywords: (R,R)-formoterol; (R,R/S,S)-formoterol; airway contraction; airway relaxation; electrical field stimulation