哮喘联盟

   摘要
   抗胆碱能生物碱类药物用于缓解支气管痉挛等呼吸道症状已有数千年历史，已被公认用于治疗慢性阻塞性肺疾病。乙酰胆碱通过毒蕈碱受体（M）调节哮喘相关的多种生理功能，包括气道肌肉张力、粘液腺分泌、炎症和重构的多种参数。此外，M受体的激活可能抑制β2肾上腺素能受体。这些发现为M受体拮抗剂在治疗哮喘中的应用提供了理论基础。短效抗胆碱药单药或与短效β受体激动剂联合可能对急性症状的缓解是有效的。长效抗胆碱药物已成为长期治疗难治性哮喘潜在的有用的药物。本篇综述对抗胆碱药物的作用机制和对哮喘的治疗作用进行分析，包括目前抗胆碱药物相关的近期指南、哮喘的近期研究、特殊人群的治疗和可能的应答预测因素。
 

（苏欣 审校）
Curr Allergy Asthma Rep. 2014 Dec;14(12):484. doi: 10.1007/s11882-014-0484-y.
 

Anticholinergics/Antimuscarinic drugs in asthma.
 

Soler X1, Ramsdell J.
 

ABSTRACT
Anticholinergic alkaloids have been used for thousands of years for the relief of bronchoconstriction and other respiratory symptoms, and their use in the treatment of chronic obstructive pulmonary disease is well established. Acetylcholine, acting through muscarinic receptor (M) receptor, modulates multiple physiologic functions pertinent to asthma including airway muscle tone, mucus gland secretion, and various parameters of inflammation and remodeling. In addition, activation of M receptors may inhibit beta2 adrenoreceptor. These observations offer the rationale for the use of M receptors antagonists in the treatment of asthma. Short-acting antimuscarinic agents may be effective alone or in combination with short-acting beta agonists for the relief of acute symptoms. Long-acting antimuscarinic agents have emerged as potentially useful in the long-term treatment of difficult-to-control asthma. This review will analyze the mechanisms of action and therapeutic role of antimuscarinic agents on asthma including current guidelines regarding antimuscarinic drugs, recent studies in asthma, special populations to consider, and possible predictors of response.
 

Curr Allergy Asthma Rep. 2014 Dec;14(12):484. doi: 10.1007/s11882-014-0484-y.