LAMA improves tissue oxygenation more than LABA in patients with COPD.

التفاصيل البيبلوغرافية
العنوان:	LAMA improves tissue oxygenation more than LABA in patients with COPD.
المؤلفون:	Perez-Bogerd S; Chest Department, Erasme University Hospital, Université Libre de Bruxelles, Brussels, Belgium., Van Muylem A; Chest Department, Erasme University Hospital, Université Libre de Bruxelles, Brussels, Belgium., Zengin S; Chest Department, Erasme University Hospital, Université Libre de Bruxelles, Brussels, Belgium., El Khloufi Y; Chest Department, Erasme University Hospital, Université Libre de Bruxelles, Brussels, Belgium., Maufroy E; Cardiopulmonary Exercise Laboratory, Faculty of Motorskill Science, Université Libre de Bruxelles, Brussels, Belgium., Faoro V; Cardiopulmonary Exercise Laboratory, Faculty of Motorskill Science, Université Libre de Bruxelles, Brussels, Belgium., Malinovschi A; Department of Medical Sciences: Clinical Physiology, Uppsala University, Uppsala, Sweden., Michils A; Chest Department, Erasme University Hospital, Université Libre de Bruxelles, Brussels, Belgium.
المصدر:	Journal of applied physiology (Bethesda, Md. : 1985) [J Appl Physiol (1985)] 2024 Jul 01; Vol. 137 (1), pp. 154-165. Date of Electronic Publication: 2024 May 09.
نوع المنشور:	Journal Article
اللغة:	English
بيانات الدورية:	Publisher: American Physiological Society Country of Publication: United States NLM ID: 8502536 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1522-1601 (Electronic) Linking ISSN: 01617567 NLM ISO Abbreviation: J Appl Physiol (1985) Subsets: MEDLINE
أسماء مطبوعة:	Original Publication: Bethesda, MD : American Physiological Society, c1985-
مواضيع طبية MeSH:	Pulmonary Disease, Chronic Obstructive/drug therapy , Pulmonary Disease, Chronic Obstructive/physiopathology , Pulmonary Disease, Chronic Obstructive/metabolism , Muscarinic Antagonists/pharmacology , Muscarinic Antagonists/administration & dosage , Adrenergic beta-2 Receptor Agonists/pharmacology , Lung/metabolism , Lung/drug effects , Lung*/physiopathology, Humans ; Male ; Female ; Aged ; Middle Aged ; Oxygen/metabolism ; Forced Expiratory Volume/drug effects ; Bronchodilator Agents/pharmacology ; Bronchodilator Agents/administration & dosage ; Tiotropium Bromide ; Drug Combinations ; Benzoxazines
مستخلص:	The effect of bronchodilators is mainly assessed with forced expiratory volume in 1 s (FEV 1 ) in chronic obstructive pulmonary disease (COPD). Their impact on oxygenation and lung periphery is less known. Our objective was to compare the action of long-acting β 2 -agonists (LABA-olodaterol) and muscarinic antagonists (LAMA-tiotropium) on tissue oxygenation in COPD, considering their impact on proximal and peripheral ventilation as well as lung perfusion. FEV 1 , Helium slope (S He ) from a single-breath washout test (S He decreases reflecting a peripheral ventilation improvement), frequency dependence of resistance (R5-R19), area under reactance (AX), lung capillary blood volume (Vc) from double diffusion (DL NO /DL CO ), and transcutaneous oxygenation (TcO 2 ) were measured before and 2 h post-LABA ( day 1 ) and LAMA ( day 3 ) in 30 patients with COPD (FEV 1 54 ± 18% pred; GOLD A 31%/B 48%/E 21%) after 5-7 days of washout, respectively. We found that TcO 2 increased more ( P = 0.03) after LAMA (11 ± 12% from baseline, P < 001) compared with LABA (4 ± 11%, P = 0.06) despite a lower FEV 1 increase ( P = 0.03) and similar S He ( P = 0.98), AX ( P = 0.63), and R5-R19 decreases ( P = 0.37). TcO 2 and S He changes were negatively correlated ( r = -0.47, P = 0.01) after LABA, not after LAMA ( r = 0.10, P = 0.65). DL NO /DL CO decreased and Vc increased after LAMA ( P = 0.04; P = 0.01, respectively) but not after LABA ( P = 0.53; P = 0.24). In conclusion, LAMA significantly improved tissue oxygenation in patients with COPD, while only a trend was observed with LABA. The mechanisms involved may differ between both drugs: LABA increased peripheral ventilation, whereas LAMA increased lung capillary blood volume. Should oxygenation differences persist over time, LAMA could arguably become the first therapeutic choice in COPD. NEW & NOTEWORTHY Long-acting muscarinic antagonists (LAMAs) significantly improved tissue oxygenation in patients with COPD, while only a trend was observed with β 2 -agonists (LABAs). The mechanisms involved may differ between drugs: increased peripheral ventilation for LABA and likely lung capillary blood volume for LAMA. This could argue for LAMA as the first therapeutic choice in COPD.
فهرسة مساهمة:	Keywords: chronic obstructive pulmonary disease; long-acting muscarinic antagonist; long-acting β2-agonist; peripheral ventilation; tissue oxygenation
المشرفين على المادة:	0 (Muscarinic Antagonists) 0 (Adrenergic beta-2 Receptor Agonists) S88TT14065 (Oxygen) 0 (Bronchodilator Agents) 0 (tiotropium-olodaterol) VD2YSN1AFD (olodaterol) XX112XZP0J (Tiotropium Bromide) 0 (Drug Combinations) 0 (Benzoxazines)
تواريخ الأحداث:	Date Created: 20240509 Date Completed: 20240711 Latest Revision: 20240711
رمز التحديث:	20240712
DOI:	10.1152/japplphysiol.00467.2023
PMID:	38722752
قاعدة البيانات:	MEDLINE

الوصف
تدمد:	1522-1601
DOI:	10.1152/japplphysiol.00467.2023