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Abstract

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Article in Japanese

Topics Series Allergy, immunology and inflammation

Bronchodilators

Jun Tamaoki 

First Department of Medicine, Tokyo Women's Medical University

ABSTRACT

Bronchodilators are widely used not only as relievers to reduce asthma attack, but also as controllers for the long-term management of asthma with all severities. It has recently been demonstrated that bronchoconstriction without additional inflammation induces airway remodeling, including basement thickening and goblet cell hyperplasia in patients with asthma. Therefore the role of bronchodilators in the treatment of asthma has become more important. Several long-acting β2-agonists and ultra-long-acting β2-agonists, such as salmeterol, formoterol, indacaterol, and vilanterol are already on the market, and current recommendations suggest the use of these drugs only in combination with inhaled corticosteroids. Anticholinergic agents are long-acting muscarinic M3 receptor antagonists, and these drugs can be used as step-up therapy for moderate persistent asthma and as add-on therapy for severe persistent asthma poorly controlled with standard combination therapy. This review will describe the pharmacology and therapeutic role of these drugs and emerging classes of bronchodilators.

KEYWORDS

Long-acting β2-agonist  Theophylline  Anticholinergic agent  Airway smooth muscle  Airway remodeling 

AJRS, 3(2): 170-177, 2014

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