The Bronchodilator and Anti-Inflammatory Effect of Long-Acting Muscarinic Antagonists in Asthma: An EAACI Position Paper.

Autor: Agache I; Faculty of Medicine, Transylvania University, Brasov, Romania., Adcock IM; Airway Disease Section, National Heart and Lung Institute, Imperial College, London, UK., Akdis CA; Swiss Institute of Allergy and Asthma Research (SIAF), University Zurich, Davos, Switzerland., Akdis M; Swiss Institute of Allergy and Asthma Research (SIAF), University Zurich, Davos, Switzerland., Bentabol-Ramos G; Pulmonology Unit, Hospital Regional Universitario de Malaga and IBIMA-Plataforma BIONAND, Malaga, Spain., van den Berge M; Department of Pulmonary Diseases, Groningen Research Institute for Asthma and COPD, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands., Boccabella C; Department of Cardiovascular and Thoracic Sciences, Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario A. Gemelli - IRCCS, Rome, Italy., Canonica WG; Personalized Medicine, Asthma and Allergy, Humanitas Clinical & Research Center, IRCCS, Rozzano, Italy.; Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy., Caruso C; UOSD DH Internal Medicine and Digestive Disease, Fondazione Policlinico A. Gemelli, IRCCS, Rome, Italy., Couto M; Immunoallergology, Hospital CUF Trindade, Porto, Portugal., Davila I; Allergy Service, Salamanca University Hospital, Faculty of Medicine, University of Salamanca, Salamanca, Spain., Drummond D; Department of Pediatric Pulmonology and Allergology, University Hospital Necker-Enfants Malades, AP-HP, Faculté de Médecine, Université Paris Cité, Inserm UMR 1138, HeKAteam, Centre de Recherche dês Cordeliers, Paris, France., Fonseca J; MEDCIDS-Department of Community Medicine, Information and Health Decision Sciences, Centre for Health Technology and Services Research, Health Research Network (CINTESIS@RISE), Faculty of Medicine, University of Porto, Porto, Portugal., Gherasim A; ALYATEC Clinical Research Center, Strasbourg University Hospital, Strasbourg, France., Del Giacco S; Unit of Allergy and Clinical Immunology, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy., Jackson DJ; Guy's Severe Asthma Centre, School of Immunology & Microbial Sciences, Guy's Hospital, King's College London, London, UK., Jutel M; Department of Clinical Immunology, Wroclaw Medical University, Wroclaw, Poland.; ALL-MED Medical Research Institute, Wroclaw, Poland., Licari A; Department of Clinical, Surgical, Diagnostic, and Pediatric Sciences, University of Pavia, Pediatric Clinic, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy., Loukides S; 2nd Respiratory Medicine Department, 'Attikon' University Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece., Moreira A; Department of Allergy and Clinical Immunology, Centro Hospitalar Universitário de São João, Porto, Portugal.; EPIUnit - Institute of Public Health, University of Porto, Porto, Portugal.; Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal., Mukherjee M; Department of Medicine, McMaster University & St Joseph's Healthcare, Hamilton, Ontario, Canada., Ojanguren I; Pneumology Service, University Hospital Vall d'Hebron, VHIR, CIBERES, Autonomous University of Barcelona, Barcelona, Spain., Palomares O; Department of Biochemistry and Molecular Biology, School of Chemistry, Complutense University, Madrid, Spain., Papi A; Respiratory Medicine, Department of Translational Medicine, University of Ferrara, Ferrara, Italy., Perez de Llano L; Pneumology Service, Lucus Augusti University Hospital, EOXI Lugo, Monforte, Cervo, Psychiatry, Radiology, Public Health, Nursing and Medicine Department of the Santiago de Compostela University, Santiago de Compostela, Spain., Price OJ; School of Biomedical Sciences, Faculty of Biological Sciences, University of Leeds, Leeds, UK.; Department of Respiratory Medicine, Leeds Teaching Hospitals NHS Trust, Leeds, UK., Rukhazde M; Center Allergy&Immunology, Tbilisi, Georgia.; Faculty of Medicine, Geomedi Teaching University, Tbilisi, Georgia., Shamji MH; National Heart and Lung Institute, Imperial College London, London, UK.; NIHR Imperial Biomedical Research Centre, London, UK., Shaw D; Respiratory Research Unit, University of Nottingham, Nottingham, UK., Sanchez-Garcia S; Allergy Unit, Hospital Infantil Universitario Niño Jesús, Madrid, Spain., Testera-Montes A; Allergy Unit, Hospital Regional Universitario de Malaga, IBIMA-Plataforma BIONAND, RICORS Inflammatory Diseases, Department of Medicine and Dermatology, Universidad de Malaga, Malaga, Spain., Torres MJ; Allergy Unit, Hospital Regional Universitario de Malaga, IBIMA-Plataforma BIONAND, RICORS Inflammatory Diseases, Department of Medicine and Dermatology, Universidad de Malaga, Malaga, Spain., Eguiluz-Gracia I; Allergy Unit, Hospital Regional Universitario de Malaga, IBIMA-Plataforma BIONAND, RICORS Inflammatory Diseases, Department of Medicine and Dermatology, Universidad de Malaga, Malaga, Spain.
Jazyk: angličtina
Zdroj: Allergy [Allergy] 2024 Dec 16. Date of Electronic Publication: 2024 Dec 16.
DOI: 10.1111/all.16436
Abstrakt: As cholinergic innervation is a major contributor to increased vagal tone and mucus secretion, inhaled long-acting muscarinic antagonists (LAMA) are a pillar for the treatment of chronic obstructive pulmonary disease and asthma. By blocking the muscarinic receptors expressed in the lung, LAMA improve lung function and reduce exacerbations in asthma patients who remained poorly controlled despite treatment with inhaled corticosteroids and long-acting β2 agonists. Asthma guidelines recommend LAMA as a third controller to be added on before the initiation of biologicals. In addition to bronchodilation, LAMA also exert anti-inflammatory and anti-fibrotic effects by inhibiting muscarinic receptors present in neutrophils, macrophages, fibroblasts and airway smooth muscle cells. Thus, besides bronchodilation, LAMA might provide additional therapeutic effects, thereby supporting an endotype-driven approach to asthma management. The Position Paper, developed by the Asthma Section of the European Academy of Allergy and Clinical Immunology, discusses the main cholinergic pathways in the lung, reviews the findings of significant clinical trials and real-life studies on LAMA use in asthma, examines the placement of these drugs in asthma clinical guidelines, and considers the potential for personalised medicine with LAMA in both adult and paediatric asthma patients.
(© 2024 European Academy of Allergy and Clinical Immunology and John Wiley & Sons Ltd.)
Databáze: MEDLINE
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