Alternative possibilities for bronchial asthma controlling in individuals with high cardiorespiratory risk

Cover Page

Cite item

Full Text

Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription or Fee Access

Abstract

Cardiovascular pathology is a frequent comorbid condition in case of bronchial asthma (BA) presence. BA exacerbations and uncontrolled use of short-acting bronchodilators (SABA) increase cardiorespiratory risk. The use of a combination of inhaled glucocorticosteroids (ICS) / long-acting β2-agonists or ICS/SABA instead of SABA as symptomatic therapy for bronchial asthma reduces the risk of exacerbation of cardiovascular diseases. The use of ICS/SABA becomes more justified in the presence of the Arg16Gly allele of the ADRB2 receptor gene, which suggests a better response to SABA comparatively to long-acting β2-agonists.

Full Text

Restricted Access

About the authors

Vitaly I. Kupaev

Mechnikov North-Western State Medical University

Author for correspondence.
Email: vk1964sam@rambler.ru
ORCID iD: 0000-0003-2639-0003
SPIN-code: 1458-5872
Scopus Author ID: 23985153900

MD, Dr. Sci. (Medicine), Professor of the Department of Family Medicine

Russian Federation, 41, Kirochnaya St., Saint Petersburg, 191015

Marina A. Pokhaznikova

Mechnikov North-Western State Medical University

Email: Marina.Pokhaznikova@szgmu.ru
ORCID iD: 0000-0001-9894-5974
SPIN-code: 3387-0226

MD, PhD (Medicine), Associate Professor of the Department of Family Medicine

Russian Federation, 41, Kirochnaya St., Saint Petersburg, 191015

Lyudmila N. Degtyareva

Mechnikov North-Western State Medical University

Email: ludmila.degtyareva@szgmu.ru
ORCID iD: 0000-0001-8375-3363
SPIN-code: 5942-8540

MD, PhD (Medicine), Associate Professor of the Department of Family Medicine

Russian Federation, 41, Kirochnaya St., Saint Petersburg, 191015

References

  1. Драпкина О.М., Авдеев С.Н., Будневский А.В., Концевая А.В., Шаповалова М.М., Трибунцева Л.В. Мультиморбидность при бронхиальной астме. Профилактическая медицина. 2024;27(1):84–89. [Drapkina OM, Avdeev SN, Budnevsky AV, Kontsevaya AV, Shapovalova MM, Tribuntseva LV. Multimorbidity in asthma. Profilakticheskaya meditsina = Russian Journal of Preventive Medicine. 2024;27(1):84–89 (In Russ.)]. EDN: WGCNXU. https://doi.org/10.17116/profmed20242701184
  2. Su X, Ren Y, Li M, Zhao X, Kong L, Kang J. Prevalence of comorbidities in asthma and nonasthma patients: A meta-analysis. Medicine (Baltimore). 2016;95(22):e3459. PMID: 27258489. PMCID: PMC4900697. https://doi.org/10.1097/MD.0000000000003459
  3. Трибунцева Л.В., Будневский А.В., Прозорова Г.Г., Чопоров О.Н., Олышева И.А., Саввина Я.М. Возможности реабилитации мультиморбидных пациентов с бронхиальной астмой и ожирением. Российский семейный врач. 2024;28(3):46–57. [Tribuntseva LV, Budnevsky AV, Prozorova GG, Choporov ON, Olysheva IA, Savvina YaM. Opportunities to rehabilitation of multimorbid patients with asthma and obesity. Rossiyskiy semeynyy vrach = Russian Family Doctor. 2024;28(3):46–57 (In Russ.)]. EDN: EFWPFW. https://doi.org/10.17816/rfd635510
  4. Global Initiative for Asthma. Global Strategy for Asthma Management and Prevention. 2024. URL: https://ginasthma.org/reports (date of access – 12.05.2025).
  5. Quint JK, Arnetrop S, Kocks JWH, Kupczyk M, Nuevo J, Plaza V et al.; SABINA North American and European Study contributors. Short-acting Beta-2-agonist exposure and severe asthma exacerbations: SABINA findings from Europe and North America. J Allergy Clin Immunol Pract. 2022;10(9):2297–2309.e10. PMID: 35364341. https://doi.org/10.1016/j.jaip.2022.02.047
  6. Bateman ED, Price DB, Wang H-C, Khattab A, Schonffeldt P, Catanzariti A et al. Short-acting β2-agonist prescriptions are associated with poor clinical outcomes of asthma: The multi-country, cross-sectional SABINA III study. Eur Respir J. 2022;59(2):2101402. PMID: 34561293. PMCID: PMC9068976. https://doi.org/10.1183/13993003.01402-2021
  7. Price D, Beekman MJHI, Mattarucco WJ, Barriga-Acevedo RM, Wang H-C, Diaz DV et al. Over-the-counter short-acting β2-agonist purchase and asthmarelated health outcomes: A post hoc analysis of the SABINA III study. NPJ Prim Care Respir Med. 2024;34(1):34. PMID: 39487159. PMCID: PMC11530521. https://doi.org/10.1038/s41533-024-00397-4
  8. Battaglia S, Benfante A, Spatafora M, Scichilone N. Asthma in the elderly: A different disease? Breathe (Sheff). 2016;12(1):18–28. PMID: 27064568. PMCID: PMC4818235. https://doi.org/10.1183/20734735.002816
  9. US Food and Drug Administration. 2012. Highlights of prescribing information. URL: https://www.accessdata.fda.gov/drugsatfda_docs/label/2012/021457s026lbl.pdf (date of access – 12.05.2025).
  10. Lipworth BJ, Newnham DM, Clark RA, Dhillon DP, Winter JH, McDevitt DG. Comparison of the relative airways and systemic potencies of inhaled fenoterol and salbutamol in asthmatic patients. Thorax. 1995;50(1):54–61. PMID: 7886650. PMCID: PMC473709. https://doi.org/10.1136/thx.50.1.54
  11. Persch H, Bizjak DA, Takabayashi K, Schober F, Winkert K, Dreyhaupt J et al. Left ventricular systolic function after inhalation ofbeta-2 agonists in healthy athletes. Sci Rep. 2024;14(1):23437. PMID: 39379505. PMCID: PMC11461498. https://doi.org/10.1038/s41598-024-74095-z
  12. Golan DE, Tashjian AH Jr, Armstrong EJ, Galanter EJ, Armstrong AW, Arnaout RA et al. Principles of pharmacology: The pathophysiologic basis of drug therapy. Baltimore: Lippincott Williams & Wilkins. 2012.
  13. Johnson AJ, Spiro S, Clarke SW. Metabolic and cardiotoxic effects of salbutamol. Br Med J. 1977;1(6063):772–73. PMID: 851719. PMCID: PMC1605651. https://doi.org/10.1136/bmj.1.6063.772-c
  14. Petruska JM, Beattie JG, Stuart BO, Pai S, Walters KM, Banks CM et al. Cardiovascular effects after inhalation of large doses of albuterol dry powder in rats, monkeys, and dogs: A species comparison. Fundam Appl Toxicol. 1997;40(1):52–62. PMID: 9398487. https://doi.org/10.1006/faat.1997.2370
  15. Chazan R, Tadeusiak W, Jaworski A, Droszcz W. Creatine kinase (CK) and creatine kinase isoenzyme (CK-MB) activity in serum before and after intravenous salbutamol administration of patients with bronchial asthma. Int J Clin Pharmacol Ther Toxicol. 1992;30(10):371–73. PMID: 1446953.
  16. Liaqat N, Jahan N, Rahman KU, Tahseen I, Anwar T, Qureshi H. Investigation of phytotherapeutic potential of herbal mixtures and their effects on salbutamol induced cardiotoxicity and hyperlipidemia in rabbits. Bot Stud. 2023;64(1):23. PMID: 37466876. PMCID: PMC10356716. https://doi.org/10.1186/s40529-023-00394-9
  17. Kabanov D, Klimovic SV, Beckerová D, Molcan M, Scurek M, Brat K et al. Salbutamol attenuates arrhythmogenic effect of aminophylline in a hPSC-derived cardiac model. Sci Rep. 2024;14(1):27399. PMID: 39521810. PMCID: PMC11550379. https://doi.org/10.1038/s41598-024-76846-4
  18. Sears MR, Lötvall J. Past, present and future-beta2-adrenoceptor agonists in asthma management. Respir Med. 2005;99(2):152–70. PMID: 15715182. https://doi.org/10.1016/j.rmed.2004.07.003
  19. Koga T, Kamimura T, Oshita Y, Narita Y, Mukaino T, Nishimura M et al. Determinants of bronchodilator responsiveness in patients with controlled asthma. J Asthma. 2006;43(1):71–74. PMID: 16448969. https://doi.org/10.1080/02770900500448662
  20. Martin AC, Zhang G, Rueter K, Khoo S-M, Bizzintino J, Hayden CM et al. Beta2-adrenoceptor polymorphisms predict response to beta2-agonists in children with acute asthma. J Asthma. 2008;45(5):383–88. PMID: 18569231. https://doi.org/10.1080/02770900801971792
  21. National Center for Biotechnology Information. Gene. ADRB2 adrenoceptor beta 2 [Homo sapiens (human)]. URL: https://www.ncbi.nlm.nih.gov/gene/154 (date of access – 12.05.2025).
  22. National Center for Biotechnology Information. 1000 Genomes Browser Phase 3. URL: https://www.ncbi.nlm.nih.gov/variation/tools/1000genomes (date of access – 12.05.2025).
  23. Finkelstein Y, Bournissen FG, Hutson JR, Shannon M. Polymorphism of the ADRB2 gene and response to inhaled beta- agonists in children with asthma: A meta-analysis. J Asthma. 2009;46(9):900–5. PMID: 19905915. https://doi.org/10.3109/02770900903199961
  24. Hikino K, Kobayashi S, Ota E, Mushiroda T, Urayama KY, Kobayashi T. A meta-analysis of the influence of ADRB2 genetic polymorphisms on albuterol (salbutamol) therapy in patients with asthma. Br J Clin Pharmacol. 2021;87(4):1708–16. PMID: 32986886. https://doi.org/10.1111/bcp.14570
  25. da C Silva V, de F Teixeira RL, do Livramento REENO, Lopes MQP, Leal-Calvo T, Filho JE et al. ADRB2 and ADCY9 sequence variations in Brazilian asthmatic patients. Curr Issues Mol Biol. 2024;46(7):6951–59. PMID: 39057056. PMCID: PMC11276142. https://doi.org/10.3390/cimb46070414
  26. Turner S, Francis B, Vijverberg S, Pino-Yanes M, Maitland-van der Zee AH, Basu K et al.; Pharmacogenomics in Childhood Asthma Consortium. Childhood asthma exacerbations and the Arg16 β2-receptor polymorphism: A meta-analysis stratified by treatment. J Allerg Clin Immunol. 2016;138(1):107–113.e5. PMID: 26774659. PMCID: PMC4931969. https://doi.org/10.1016/j.jaci.2015.10.045
  27. Slob EMA, Vijverberg SJH, Ruffles T, Noij LCE, Biermann J, Brouwer AFJ, van den Brink K et al. Genotype-guided asthma treatment reduces exacerbations in children: Meta-analysis of two randomized control trials. Allergy. 2025;80(4):1006–14. PMID: 39723595. PMCID: PMC11969299. https://doi.org/10.1111/all.16438
  28. Bartemes KR, Kita H. Dynamic role of epithelium-derived cytokines in asthma. Clin Immunol. 2012;143(3):222–35. PMID: 22534317. PMCID: PMC3358585. https://doi.org/10.1016/j.clim.2012.03.001
  29. Black JL, Oliver BGG, Roth M. Molecular mechanisms of combination therapy with inhaled corticosteroids and long-acting beta-agonists. Chest. 2009;136(4):1095–1100. PMID: 19809050. https://doi.org/10.1378/chest.09-0354
  30. Koziol-White C, Johnston TB, Corpuz ML, Cao G, Orfanos S, Parikh V et al. Budesonide enhances agonist-induced bronchodilation in human small airways by increasing cAMP production in airway smooth muscle. Am J Physiol Lung Cell Mol Physiol. 2020;318(2):L345–L355. PMID: 31747297. PMCID: PMC7052668. https://doi.org/10.1152/ajplung.00393.2019
  31. Papi A, Chipps BE, Beasley R, Panettieri RA Jr, Israel E, Cooper M et al. Albuterol-budesonide fixed-dose combination rescue inhaler for asthma. N Engl J Med. 2022;386(22):2071–83. PMID: 35569035. https://doi.org/10.1056/nejmoa2203163
  32. Truong J, Cauthon KAB. Combination inhaled corticosteroid and short-acting beta2 agonist (ICS-SABA) use for older adults with asthma. Sr Care Pharm. 2025;40(1):3–9. PMID: 39747808. https://doi.org/10.4140/TCP.n.2025.3

Supplementary files

Supplementary Files
Action
1. JATS XML
Download

Copyright (c) 2025 Bionika Media