The bronchodilator and anti‐inflammatory effect of long‐Acting muscarinic antagonists in asthma: an EAACI position paper

[EN]As cholinergic innervation is a major contributor to increased vagal tone and mucus secretion, inhaled long-acting muscarinic antagonists (LAMA) are a pillar for the treatment of chronic obstructive pulmonary disease and asthma. By blocking the muscarinic receptors expressed in the lung, LAMA im...

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Autores: Agache, I., Adcock, I. M., Akdis, C. A., Akdis, M., Bentabol Ramos, G., van den Berge, M., Bocabella, C., Canonica, W. G., Caruso, C., Couto, M., Dávila González, Ignacio Jesús, Drummond, D., Fonseca, J., Gherasim, A., del Giacco, S., Jackson, D. J., Jute, M., Licari, A., Loukides, S., Moreira, A., Mukherjee, M., Ojanguren, I., Palomares, O., Papi, A., Pérez del Llano, L., Price, O. J., Rukhazde, M., Shamji, M. H., Shaw, D., Sánchez García, S., Testera Montes, A., Torres, M. J., Eguiluz Gracia, I.
Tipo de documento: artigo
Estado:Versão publicada
Data de publicação:2024
País:España
Recursos:Universidad de Salamanca (USAL)
Repositório:GREDOS. Repositorio Institucional de la Universidad de Salamanca
OAI Identifier:oai:gredos.usal.es:10366/168589
Acesso em linha:http://hdl.handle.net/10366/168589
Access Level:Acceso aberto
Palavra-chave:Acetylcholine
Asthma
Bronchodilator
Endotype
Precision medicine
Long-acting muscarinic antagonist
Muscarinic Antagonists
Anti-Asthmatic Agents
Bronchodilator Agents
3207.01 Alergias
3208.08 Mecanismos de Acción de Los Medicamentos
3205.08 Enfermedades Pulmonares
asma
acetilcolina
antiasmáticos
broncodilatadores
antagonistas muscarínicos
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oai_identifier_str oai:gredos.usal.es:10366/168589
network_acronym_str ES
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repository_id_str
spelling The bronchodilator and anti‐inflammatory effect of long‐Acting muscarinic antagonists in asthma: an EAACI position paperAgache, I.Adcock, I. M.Akdis, C. A.Akdis, M.Bentabol Ramos, G.van den Berge, M.Bocabella, C.Canonica, W. G.Caruso, C.Couto, M.Dávila González, Ignacio JesúsDrummond, D.Fonseca, J.Gherasim, A.del Giacco, S.Jackson, D. J.Jute, M.Licari, A.Loukides, S.Moreira, A.Mukherjee, M.Ojanguren, I.Palomares, O.Papi, A.Pérez del Llano, L.Price, O. J.Rukhazde, M.Shamji, M. H.Shaw, D.Sánchez García, S.Testera Montes, A.Torres, M. J.Eguiluz Gracia, I.AcetylcholineAsthmaBronchodilatorEndotypePrecision medicineLong-acting muscarinic antagonistAsthmaMuscarinic AntagonistsAcetylcholineAnti-Asthmatic AgentsBronchodilator Agents3207.01 Alergias3208.08 Mecanismos de Acción de Los Medicamentos3205.08 Enfermedades Pulmonaresasmaacetilcolinaantiasmáticosbroncodilatadoresantagonistas muscarínicos[EN]As cholinergic innervation is a major contributor to increased vagal tone and mucus secretion, inhaled long-acting muscarinic antagonists (LAMA) are a pillar for the treatment of chronic obstructive pulmonary disease and asthma. By blocking the muscarinic receptors expressed in the lung, LAMA improve lung function and reduce exacerbations in asthma patients who remained poorly controlled despite treatment with inhaled corticosteroids and long-acting β2 agonists. Asthma guidelines recommend LAMA as a third controller to be added on before the initiation of biologicals. In addition to bronchodilation, LAMA also exert anti-inflammatory and anti-fibrotic effects by inhibiting muscarinic receptors present in neutrophils, macrophages, fibroblasts and airway smooth muscle cells. Thus, besides bronchodilation, LAMA might provide additional therapeutic effects, thereby supporting an endotype-driven approach to asthma management. The Position Paper, developed by the Asthma Section of the European Academy of Allergy and Clinical Immunology, discusses the main cholinergic pathways in the lung, reviews the findings of significant clinical trials and real-life studies on LAMA use in asthma, examines the placement of these drugs in asthma clinical guidelines, and considers the potential for personalised medicine with LAMA in both adult and paediatric asthma patients.European Academy of Allergy and Clinical ImmunologyEuropean Academy of Allergy and Clinical ImmunologyWiley-Blackwel202620262024info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttp://hdl.handle.net/10366/168589reponame:GREDOS. Repositorio Institucional de la Universidad de Salamancainstname:Universidad de Salamanca (USAL)InglésAttribution-NonCommercial-NoDerivatives 4.0 Internacionalhttp://creativecommons.org/licenses/by-nc-nd/4.0/info:eu-repo/semantics/openAccessoai:gredos.usal.es:10366/1685892026-06-07T06:28:51Z
dc.title.none.fl_str_mv The bronchodilator and anti‐inflammatory effect of long‐Acting muscarinic antagonists in asthma: an EAACI position paper
title The bronchodilator and anti‐inflammatory effect of long‐Acting muscarinic antagonists in asthma: an EAACI position paper
spellingShingle The bronchodilator and anti‐inflammatory effect of long‐Acting muscarinic antagonists in asthma: an EAACI position paper
Agache, I.
Acetylcholine
Asthma
Bronchodilator
Endotype
Precision medicine
Long-acting muscarinic antagonist
Asthma
Muscarinic Antagonists
Acetylcholine
Anti-Asthmatic Agents
Bronchodilator Agents
3207.01 Alergias
3208.08 Mecanismos de Acción de Los Medicamentos
3205.08 Enfermedades Pulmonares
asma
acetilcolina
antiasmáticos
broncodilatadores
antagonistas muscarínicos
title_short The bronchodilator and anti‐inflammatory effect of long‐Acting muscarinic antagonists in asthma: an EAACI position paper
title_full The bronchodilator and anti‐inflammatory effect of long‐Acting muscarinic antagonists in asthma: an EAACI position paper
title_fullStr The bronchodilator and anti‐inflammatory effect of long‐Acting muscarinic antagonists in asthma: an EAACI position paper
title_full_unstemmed The bronchodilator and anti‐inflammatory effect of long‐Acting muscarinic antagonists in asthma: an EAACI position paper
title_sort The bronchodilator and anti‐inflammatory effect of long‐Acting muscarinic antagonists in asthma: an EAACI position paper
dc.creator.none.fl_str_mv Agache, I.
Adcock, I. M.
Akdis, C. A.
Akdis, M.
Bentabol Ramos, G.
van den Berge, M.
Bocabella, C.
Canonica, W. G.
Caruso, C.
Couto, M.
Dávila González, Ignacio Jesús
Drummond, D.
Fonseca, J.
Gherasim, A.
del Giacco, S.
Jackson, D. J.
Jute, M.
Licari, A.
Loukides, S.
Moreira, A.
Mukherjee, M.
Ojanguren, I.
Palomares, O.
Papi, A.
Pérez del Llano, L.
Price, O. J.
Rukhazde, M.
Shamji, M. H.
Shaw, D.
Sánchez García, S.
Testera Montes, A.
Torres, M. J.
Eguiluz Gracia, I.
author Agache, I.
author_facet Agache, I.
Adcock, I. M.
Akdis, C. A.
Akdis, M.
Bentabol Ramos, G.
van den Berge, M.
Bocabella, C.
Canonica, W. G.
Caruso, C.
Couto, M.
Dávila González, Ignacio Jesús
Drummond, D.
Fonseca, J.
Gherasim, A.
del Giacco, S.
Jackson, D. J.
Jute, M.
Licari, A.
Loukides, S.
Moreira, A.
Mukherjee, M.
Ojanguren, I.
Palomares, O.
Papi, A.
Pérez del Llano, L.
Price, O. J.
Rukhazde, M.
Shamji, M. H.
Shaw, D.
Sánchez García, S.
Testera Montes, A.
Torres, M. J.
Eguiluz Gracia, I.
author_role author
author2 Adcock, I. M.
Akdis, C. A.
Akdis, M.
Bentabol Ramos, G.
van den Berge, M.
Bocabella, C.
Canonica, W. G.
Caruso, C.
Couto, M.
Dávila González, Ignacio Jesús
Drummond, D.
Fonseca, J.
Gherasim, A.
del Giacco, S.
Jackson, D. J.
Jute, M.
Licari, A.
Loukides, S.
Moreira, A.
Mukherjee, M.
Ojanguren, I.
Palomares, O.
Papi, A.
Pérez del Llano, L.
Price, O. J.
Rukhazde, M.
Shamji, M. H.
Shaw, D.
Sánchez García, S.
Testera Montes, A.
Torres, M. J.
Eguiluz Gracia, I.
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Acetylcholine
Asthma
Bronchodilator
Endotype
Precision medicine
Long-acting muscarinic antagonist
Asthma
Muscarinic Antagonists
Acetylcholine
Anti-Asthmatic Agents
Bronchodilator Agents
3207.01 Alergias
3208.08 Mecanismos de Acción de Los Medicamentos
3205.08 Enfermedades Pulmonares
asma
acetilcolina
antiasmáticos
broncodilatadores
antagonistas muscarínicos
topic Acetylcholine
Asthma
Bronchodilator
Endotype
Precision medicine
Long-acting muscarinic antagonist
Asthma
Muscarinic Antagonists
Acetylcholine
Anti-Asthmatic Agents
Bronchodilator Agents
3207.01 Alergias
3208.08 Mecanismos de Acción de Los Medicamentos
3205.08 Enfermedades Pulmonares
asma
acetilcolina
antiasmáticos
broncodilatadores
antagonistas muscarínicos
description [EN]As cholinergic innervation is a major contributor to increased vagal tone and mucus secretion, inhaled long-acting muscarinic antagonists (LAMA) are a pillar for the treatment of chronic obstructive pulmonary disease and asthma. By blocking the muscarinic receptors expressed in the lung, LAMA improve lung function and reduce exacerbations in asthma patients who remained poorly controlled despite treatment with inhaled corticosteroids and long-acting β2 agonists. Asthma guidelines recommend LAMA as a third controller to be added on before the initiation of biologicals. In addition to bronchodilation, LAMA also exert anti-inflammatory and anti-fibrotic effects by inhibiting muscarinic receptors present in neutrophils, macrophages, fibroblasts and airway smooth muscle cells. Thus, besides bronchodilation, LAMA might provide additional therapeutic effects, thereby supporting an endotype-driven approach to asthma management. The Position Paper, developed by the Asthma Section of the European Academy of Allergy and Clinical Immunology, discusses the main cholinergic pathways in the lung, reviews the findings of significant clinical trials and real-life studies on LAMA use in asthma, examines the placement of these drugs in asthma clinical guidelines, and considers the potential for personalised medicine with LAMA in both adult and paediatric asthma patients.
publishDate 2024
dc.date.none.fl_str_mv 2024
2026
2026
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv http://hdl.handle.net/10366/168589
url http://hdl.handle.net/10366/168589
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.rights.none.fl_str_mv Attribution-NonCommercial-NoDerivatives 4.0 Internacional
http://creativecommons.org/licenses/by-nc-nd/4.0/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv Attribution-NonCommercial-NoDerivatives 4.0 Internacional
http://creativecommons.org/licenses/by-nc-nd/4.0/
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv Wiley-Blackwel
publisher.none.fl_str_mv Wiley-Blackwel
dc.source.none.fl_str_mv reponame:GREDOS. Repositorio Institucional de la Universidad de Salamanca
instname:Universidad de Salamanca (USAL)
instname_str Universidad de Salamanca (USAL)
reponame_str GREDOS. Repositorio Institucional de la Universidad de Salamanca
collection GREDOS. Repositorio Institucional de la Universidad de Salamanca
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15,198674