Anti-Asthma Medications: Too Much of a Good Thing?
Monday, August 18, 2003
Source - Journal of Clinical Investigation
In an unusual paradox, asthmatics that are chronically
treated with bronchodilating beta-agonist medications
such as albuterol, ventolin, and salbutamol may
ultimately develop increased sensitivity to airway
constriction and experience exacerbation of their
condition. A new study by Stephen Liggett and colleagues
at the University of Cincinnati in the August 15, 2003,
issue of the Journal of Clinical Investigation describes
a responsible mechanism for this adverse reaction and
reveals a potential new therapeutic target in the
treatment of asthma.
Inhaled selective beta -agonists are the most widely used
treatment for the acute relief of asthma symptoms.
Administered to asthmatic patients via an inhaler,
nebulizer, in tablet or liquid form, or injection, they
cause airway relaxation and reduced airway responsiveness
to nonspecific contractile stimuli. This is achieved by
drug binding to the beta2-adrenergic receptor (beta2AR).
Despite the ability of these agents to immediately
reverse airway obstruction, there has been ongoing
concern that the use of these drugs may be associated
with harmful outcomes. Some, but not all, studies have
revealed that regular scheduled use (e.g., multiple times
daily, every day) of inhaled beta-agonists has resulted
in a loss of control over the condition, which can
manifest as longer asthmatic attacks and post-treatment
airway hyperresponsiveness.
To date, the evidence has suggested that a
desensitization of the beta2AR is responsible. . . .
[...]
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