PMID- 26293997
OWN - NLM
STAT- MEDLINE
DCOM- 20151125
LR  - 20161025
IS  - 1941-9260 (Electronic)
IS  - 0032-5481 (Linking)
VI  - 127
IP  - 7
DP  - 2015
TI  - Bronchodilators, receptors and cross-talk: Together is better?
PG  - 771-80
LID - 10.1080/00325481.2015.1080589 [doi]
AB  - The most widely used maintenance therapies in chronic obstructive pulmonary 
      disease (COPD) are long-acting muscarinic antagonists (LAMAs), and a number of 
      these drugs are now available in combination with long-acting beta2-agonists 
      (LABAs). LAMAs inhibit the parasympathetic muscarinic pathway, while LABAs, as 
      sympathomimetics, reduce airway smooth muscle (ASM) tone. As well as directly 
      controlling the constriction and relaxation of ASM, muscarinic and adrenergic 
      receptors are found on inflammatory cells, and drugs that target these receptors 
      may also reduce inflammation in COPD. Evidence suggests that the muscarinic and 
      adrenergic pathways cross-talk at the level of neuronal input to the ASM via 
      second-messenger pathways within ASM cells. Although the cross-talk is not 
      completely understood, pharmacologically targeting both pathways in COPD can 
      maximize bronchodilation. Combining LAMAs and LABAs demonstrated improved 
      efficacy compared with the individual therapies and so, for greater convenience, 
      several fixed-dose combinations for once-daily use have been developed. These 
      fixed-dose combinations demonstrate improvements in both lung-function and 
      patient-reported outcomes compared with well-established monotherapies, with 
      similar tolerability profiles to the individual agents.
FAU - Panettieri, Reynold A Jr
AU  - Panettieri RA Jr
AD  - a University of Pennsylvania, Perelman School of Medicine , Philadelphia, PA, 
      USA.
LA  - eng
GR  - P01 HL067663/HL/NHLBI NIH HHS/United States
GR  - P30 ES013508/ES/NIEHS NIH HHS/United States
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PT  - Review
DEP - 20150819
PL  - England
TA  - Postgrad Med
JT  - Postgraduate medicine
JID - 0401147
RN  - 0 (Adrenergic beta-2 Receptor Agonists)
RN  - 0 (Bronchodilator Agents)
RN  - 0 (Delayed-Action Preparations)
RN  - 0 (Muscarinic Antagonists)
RN  - 0 (Receptors, Adrenergic)
RN  - 0 (Receptors, Muscarinic)
SB  - IM
MH  - Adrenergic beta-2 Receptor Agonists/*pharmacology
MH  - Bronchodilator Agents/pharmacology
MH  - Delayed-Action Preparations
MH  - Drug Therapy, Combination/methods
MH  - Humans
MH  - Medication Therapy Management
MH  - Muscarinic Antagonists/*pharmacology
MH  - *Pulmonary Disease, Chronic Obstructive/drug therapy/metabolism
MH  - Receptors, Adrenergic/*metabolism
MH  - Receptors, Muscarinic/*metabolism
MH  - Treatment Outcome
OTO - NOTNLM
OT  - Chronic obstructive pulmonary disease
OT  - antimuscarinic
OT  - bronchodilation
OT  - combination therapy
OT  - beta2-agonist
EDAT- 2015/08/22 06:00
MHDA- 2015/12/15 06:00
CRDT- 2015/08/22 06:00
PHST- 2015/08/22 06:00 [entrez]
PHST- 2015/08/22 06:00 [pubmed]
PHST- 2015/12/15 06:00 [medline]
AID - 10.1080/00325481.2015.1080589 [doi]
PST - ppublish
SO  - Postgrad Med. 2015;127(7):771-80. doi: 10.1080/00325481.2015.1080589. Epub 2015 
      Aug 19.