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The Airway Circulation: A New Therapeutic Target in Airway Disease

Wanner A.

RDD Europe 2009. Volume 1, 2009: 1-14.

Abstract:

The airway circulation plays critical roles in the manifestation and treatment of airway diseases such as asthma and COPD by participating in airway remodeling and acting as the conduit for the recruitment of inflammatory cells, the delivery of systemic drugs to the airways, and clearance of inhaled drugs, following absorption. Given these diverse functions of the airway circulation, its regulation must have therapeutic implications. By combining in vitro studies with in vivo observations, we have shown that inhaled β2-adrenergic agonists and glucocorticosteroids, widely used drugs in the management of airway disease, have profound effects on the biology of airway vascular cells and on airway blood flow, and that the two classes of agent exhibit non-genomic pharmacological interactions at the local level. For example, changes in disposition of beta adrenergic drugs may be moderated by acute effects of inhaled corticosteroids. Our work suggests that in addition to their bronchodilator and anti-inflammatory actions, these drugs also have potentially beneficial effects on the airway circulation in patients with either asthma or COPD.