Interactions between Corticosteroids and 2-Agonists in Asthma and Chronic Obstructive Pulmonary Disease
- 1 November 2004
- journal article
- research article
- Published by American Thoracic Society in Proceedings of the American Thoracic Society
- Vol. 1 (3) , 200-206
- https://doi.org/10.1513/pats.200402-010ms
Abstract
The combination of a long-acting β2-agonist (LABA) and an inhaled corticosteroid is more efficacious in asthma and chronic obstructive pulmonary disease (COPD) than other combination therapies or than either alone. Corticosteroids may regulate β2-receptor function by increasing expression of the receptor, restoring G-protein/β2-receptor coupling, and inhibiting β2-receptor downregulation. LABAs may prime the glucocorticoid receptor and affect its nuclear localization by modulating glucocorticoid receptor phosphorylation. These mechanisms suggest the possibility of interactions between the two classes of drugs at the molecular and receptor levels. Indeed, there is evidence that corticosteroid/β2-agonist combination therapy has complementary, additive, and synergistic inhibitory effects on proinflammatory signaling pathways, inflammatory mediator release, and recruitment and survival of inflammatory cells. In the asthmatic patient, this is reflected in enhanced anti-inflammatory activity with combination th...Keywords
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