Agache, I. orcid.org/0000-0001-7994-364X, Adcock, I.M. orcid.org/0000-0003-2101-8843, Akdis, C.A. orcid.org/0000-0001-8020-019X et al. (30 more authors) (2024) The Bronchodilator and Anti‐Inflammatory Effect of Long‐Acting Muscarinic Antagonists in Asthma: An EAACI Position Paper. Allergy. ISSN 0105-4538
Abstract
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.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © 2024 European Academy of Allergy and Clinical Immunology and John Wiley & Sons Ltd. This is the peer reviewed version of the following article: Agache, I. , Adcock, I.M. , Akdis, C.A. et al. (30 more authors) (2024) The Bronchodilator and Anti‐Inflammatory Effect of Long‐Acting Muscarinic Antagonists in Asthma: An EAACI Position Paper. Allergy. ISSN 0105-4538, which has been published in final form at https://doi.org/10.1111/all.16436. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions. This article may not be enhanced, enriched or otherwise transformed into a derivative work, without express permission from Wiley or by statutory rights under applicable legislation. Copyright notices must not be removed, obscured or modified. The article must be linked to Wiley’s version of record on Wiley Online Library and any embedding, framing or otherwise making available the article or pages thereof by third parties from platforms, services and websites other than Wiley Online Library must be prohibited. |
Keywords: | acetylcholine; asthma; bronchodilator; endotype; long-acting muscarinic antagonists; precision medicine |
Dates: |
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Institution: | The University of Leeds |
Academic Units: | The University of Leeds > Faculty of Biological Sciences (Leeds) > School of Biomedical Sciences (Leeds) |
Depositing User: | Symplectic Publications |
Date Deposited: | 18 Dec 2024 16:14 |
Last Modified: | 27 Jan 2025 11:55 |
Status: | Published online |
Publisher: | Wiley |
Identification Number: | 10.1111/all.16436 |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:220919 |
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Filename: Agache et al. 2024 - Allergy.pdf
