Bronkhoprotektivnyy effekt tiotropiya pri khronicheskoy obstruktivnoy bolezni legkikh


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Abstract

In this article presents the results of a study of tiotropium bronchoprotective effect and comparison of its clinical efficacy in chronic obstructive pulmonary disease (COPD) patients, depending on a bronchial reactivity level. Bronchial hyperresponsiveness (BHR) was decreased after the first dose of tiotropium and was maintained at 6 months of therapy (р < 0,05). The BHR reduction at the end of the treatment period was accompanied by a significant decrease symptoms expression and frequency of COPD exacerbations, improvement of quality of life in comparison to baseline parameters (p < 0,05) and patients without BHR. Tiotropium improves clinical-functional status of COPD patients and significantly reduces of bronchial reactivity level in the initial high values. COPD patients with BHR phenotype respond to tiotropium therapy better than patients without BHR.

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B. A Chernyak

I. N Trofimenko

References

  1. PR, J-L, Caillaud D, et al. Clinical COPD phenotypes: a novel approach using principal component and cluster analyses. Eur Respir J 2010;36:531-39.
  2. Han MK, Agusti A, Calverley PM, et al. COPD phenotypes: The future of COPD. Am J Respir Crit Care Med 2010;182:598-604.
  3. Овчаренко С.И. К вопросу о фенотипах хронической обструктивной болезни легких // Фарматека 2010. № 4. С. 44-6.
  4. Kanner RE, Connett JE, Altose MD, et al. Gender difference in airway hyperresponsiveness in smokers with mild COPD. The Lung Health Study. Am J Respir Crit Care Med 1994; 150(4):956-61.
  5. Yang SC, Lin BY. Comparison of Airway Hyperreactivity in Chronic Obstructive Pulmonary Disease and Asthma. Chang Gung Med J 2010;33:515-23.
  6. Трофименко И.Н., Черняк Б.А. Бронхиальная гиперреактивность как фенотипическая характеристика хронической обструктивной болезнью легких // Пульмонология 2011. № 4. С. 49-53.
  7. Brutsche MH, Downs SH, Schindler C, et al. Bronchial hyperresponsiveness and the development of asthma and COPD in asymptomatic individuals: SAPALDIA Cohort Study. Thorax 2006;61:671-77.
  8. Xu X, Rijcken B, Schouten JP, et al. Airways responsiveness and development and remission of chronic respiratory symptoms in adults. Lancet 1997;350:1431-34.
  9. De Marco R, Accordini S, Marcon A, et al. Risk factors for chronic obstructive pulmonary disease in a European cohort of young adults. Am J Respir Crit Care Med 2011;183(7):891-97.
  10. Tashkin DP, Altose MD, Connett JE, et al. Methacholine reactivity predicts changes in lung function over time in smokers with early chronic obstructive pulmonary disease. The Lung Health Study Research Group. Am J Respir Crit Care Med 1996;153:1802-11.
  11. Hospers JJ, Postma DS, Rijcken B, et al. Histamine airway hyper-responsiveness and mortality from chronic obstructive pulmonary disease: a cohort study. Lancet 2000;356:1313-17.
  12. Grootendorst DC, Rabe KF. Mechanisms of bronchial hyperreactivity in asthma and chronic obstructive pulmonary disease. The Proceedings of the American Thoracic Society 2004; 1:77-87.
  13. Wise RA, Kanner RE, Lindgren P, et al. The effect of smoking intervention and an inhaled bronchodilator on airways reactivity in COPD: the Lung Health Study. Chest 2003;124:449-58.
  14. Postma DS, Kerstjens HA. Characteristics of airway hyperresponsiveness in asthma and chronic obstructive pulmonary disease. Am J Respir Crit Care Med 1998;158:187-92.
  15. Lancas T, Kasahara DI, Gross JL, et al. Cholinergic hyperresponsiveness of peripheral lung parenchyma in chronic obstructive pulmonary disease. Respiration 2011;82:177-84.
  16. Fisher JT, Vincent SG, Gomeza J, et al. Loss of vagally mediated bradycardia and bronchoconstriction in mice lacking M2 or M3 muscarinic acetylcholine receptors. FASEB J 2004;18(6):711-13.
  17. Belmonte KE. Cholinergic pathways in the lungs and anticholinergic therapy for chronic obstructive pulmonary disease. Proc Am Thorac Soc 2005;2:297-304.
  18. Moulton BC, Fryer AD. Muscarinic receptor antagonists, from folklore to pharmacology; finding drugs that actually work in asthma and COPD. Br J Pharmacol 2011;163(1):44-52.
  19. O'Connor BJ, Towse LJ, Barnes PJ. Prolonged effect of tiotropium bromide on methacholine-induced bronchoconstriction in asthma. Am J Respir Crit Care Med 1996;154:876-80.
  20. Gosens R, Zaagsma J, Meurs H, et al. Muscarinic receptor signaling in the pathophysiology of asthma and COPD. Respir Res 2006;7(1):73.
  21. Peters SP, Kunselman SJ, Icitovic N, et al. Tiotropium Bromide Step-Up Therapy for Adults with Uncontrolled Asthma. N Engl J Med 2010;363:1715-26.
  22. Cao R, Dong XW, Jiang JX, et al. M3 muscarinic receptor antagonist bencycloquidium bromide attenuates allergic airway inflammation, hyperresponsiveness and remodeling in mice. Eur J Pharmacol 2011;655:83-90.
  23. Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Pulmonary Disease, Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2011. www. goldcopd.org.
  24. Gulsvik A, Refvem OK. Ascoring system on respiratory symptoms. Eur Respir J 1988;1:428-32.
  25. Klein G, Kohler D, Bauer CP, et al. Standardization of inhalation challenges for measuring the unspecific bronchial inhalation challenge by reservuar-method. Pneumologie 1991;45:60-4.
  26. Стандартизация легочных функциональных тестов. Пер. с англ. / Под ред. А.Г. Чучалина. М., 1993. С. 68-9.
  27. Трофименко И.Н., Батунова Е.В., Черняк Б.А. Взаимосвязь бронхиальной гиперреактивности и воспаления при хронической обструктивной болезни легких // Сиб. мед. журнал 2012; в печати.
  28. Troosters T, Celli B, Lystig T, et al. Tiotropium as a first maintenance drug in COPD: secondary analysis of the UPLIFT® trial. Eur Respir J 2010;36(1):65-73.
  29. Bohling F, Lieder N, Kohlmann UC, et al. Tiotropium suppresses acetylcholine-induced release of chemotactic mediators in vitro. Respir Med 2007;101(11):2386-94.
  30. Kolahian S, Gosens R. Cholinergic Regulation of Airway Inflammation and Remodelling J Allergy (Cairo) 2012;681258.
  31. Selivanova PA, Kulikov ES, Kozina OV, et al. Differential expression of the β2-adrenoreceptor and M3-cholinoreceptor genes in bronchial mucosa of patients with asthma and chronic obstructive pulmonary disease. Ann Allergy Asthma Immunol 2012;108:39-43.

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