Department of Psychiatry, Neurobiology, Pharmacology and Biotechnology, University of Pisa, Italy.
Br J Pharmacol. 2011 Jan;162(2):378-91. doi: 10.1111/j.1476-5381.2010.01021.x.
β₂-Adrenoceptor agonists are important therapeutic agents in the treatment of asthma and chronic obstructive pulmonary disease. The regular use of these drugs has been associated with proasthmatic-like changes that limit their efficacy and increase the risk of severe adverse reactions. We investigated whether the peroxisome-proliferator-activated receptor (PPAR)γ agonist rosiglitazone modulated salbutamol-induced β₂-adrenoceptor desensitization in vivo and in vitro.
An in vivo model of homologous β₂-adrenoceptor desensitization, established in guinea-pigs by administering salbutamol continuously, was used to study the ability of rosiglitazone to prevent β₂-adrenoceptor tolerance. In vitro experiments on human bronchial smooth muscle cells were performed to increase the clinical relevance of the study.
In tracheal smooth muscle tissues from desensitized animals, we observed a decrease in the protective effect of salbutamol on carbachol-induced contraction, a hyperresponsiveness to cholinergic stimuli, a modest underexpression of β₂-adrenoceptor gene and a marked decrease in β-adrenoceptor number, relative to control values. Treatment with rosiglitazone preserved salbutamol relaxant activity, mitigated carbachol hyperresponsiveness and partially restored β₂-adrenoceptor binding sites in tracheal tissues from homologously desensitized animals. The highly selective PPARγ agonist, GW1929, reproduced the effect of rosiglitazone, in vivo. In vitro β₂-adrenoceptor desensitization decreased salbutamol-mediated cAMP production, without affecting forskolin responses and β₂-adrenoceptor expression. Rosiglitazone and 15-deoxy-Δ¹²(,)¹⁴-prostaglandin J₂ restored salbutamol sensitivity in homologously desensitized cells.
These data suggest a potential pharmacodynamic interaction between PPARγ agonists and salbutamol on airway smooth muscle responsiveness, supporting the therapeutic potential of this combination in chronic airway disease.
β₂-肾上腺素受体激动剂是治疗哮喘和慢性阻塞性肺疾病的重要治疗药物。这些药物的常规使用与类哮喘变化有关,限制了它们的疗效,并增加了严重不良反应的风险。我们研究了过氧化物酶体增殖物激活受体(PPAR)γ激动剂罗格列酮是否能调节体内和体外沙丁胺醇诱导的β₂-肾上腺素受体脱敏。
通过连续给予沙丁胺醇,在豚鼠中建立同源β₂-肾上腺素受体脱敏的体内模型,研究罗格列酮预防β₂-肾上腺素受体耐受的能力。在人支气管平滑肌细胞的体外实验中,增加了研究的临床相关性。
在脱敏动物的气管平滑肌组织中,我们观察到沙丁胺醇对乙酰甲胆碱诱导收缩的保护作用降低,对胆碱能刺激的高反应性,β₂-肾上腺素受体基因表达适度下调,β-肾上腺素受体数量显著减少,与对照值相比。罗格列酮治疗保留了沙丁胺醇的舒张活性,减轻了乙酰甲胆碱的高反应性,并部分恢复了同源脱敏动物气管组织中的β₂-肾上腺素受体结合位点。高选择性 PPARγ激动剂 GW1929,在体内复制了罗格列酮的作用。体外β₂-肾上腺素受体脱敏降低了沙丁胺醇介导的 cAMP 产生,而不影响 forskolin 反应和β₂-肾上腺素受体表达。罗格列酮和 15-脱氧-Δ¹²(,)¹⁴-前列腺素 J₂恢复了同源脱敏细胞中沙丁胺醇的敏感性。
这些数据表明 PPARγ激动剂和沙丁胺醇之间在气道平滑肌反应性方面存在潜在的药效学相互作用,支持这种组合在慢性气道疾病中的治疗潜力。