Tiotropium Ameliorates Symptoms in Patients with Chronic Airway Mucus Hypersecretion which is Resistant to Macrolide Therapy

Abstract

Objective Low-dose, long-term

Tiotropium attenuates IL-13-induced goblet cell metaplasia of human airway epithelial cells

“…Results from our study imply that mucus hypersecretion might also be affected by tiotropium treatment. Previously, tiotropium has been shown to be effective in reducing sputum levels in patients with chronic airway mucus hypersecretion 34. Although it has been proposed that anticholinergic treatment might impair sputum clearance, there is now increasing evidence that reducing the volume of sputum without altering viscoelasticity with anticholinergic agents is beneficial for patients with chronic mucus hypersecretion 35.…”

Acetylcholine beyond bronchoconstriction: roles in inflammation and remodeling

“…This is supported by a study demonstrating that tiotropium inhibits goblet cell metaplasia of human airway epithelial cells [31]. Tiotropium has been shown to reduce sputum levels in patients with chronic mucus hypersecretion [76]. Although the concern has been expressed that anticholinergics desiccate mucus, thereby increasing the viscosity and making the mucus more difficult to clear, there is now data to support that anticholinergics are beneficial for patients with mucus hypersecretion [77].…”

Effect of Inhaled Tiotropium on Spirometric Parameters in Patients with Tuberculous Destroyed Lung

“…Also FEV 1 value was significantly improved after 3 months of treatment with tiotropium (mean improvement in FEV 1 0.11 L, p=0.016). The authors insisted that these beneficial effects may have been due to the suppression of air way secretion through the anti-cholinergic effect of tiotropium on the submucosal gland12. Their pulmonary functions test showed a mild but significant improvement in the FEV 1 and FVC after treatment with tiotropium.…”

“…The parasympathetic activity in the airway induces bronchial smooth muscle contraction and mucus production via the muscarinic receptors located on smooth muscle cells and within the submucosal glands. Tiotropium acts as a muscarinic receptor antagonist that is able to improve airway limitations while also suppressing airway secretion12,13,14.…”