Current and Novel Bronchodilators in Respiratory Disease

Domenico Spina


Curr Opin Pulm Med 

In This Article

Novel Bronchodilators

The development of novel bronchodilators is motivated by safety concerns of currently used inhaled drugs, the potential for loss in bronchoprotection of the β2-agonist class, and lack of disease modifying properties of inhaled bronchodilators. A number of clinical studies have reported bronchodilation/bronchoprotection by new drug classes (Table 1) including RPL554, a 'bifunctional' molecule that provides long-lasting bronchodilation and anti-inflammatory activity via inhibition of PDE3/4. Other drugs classes that could exert this dual activity include E prostanoid receptor 4 agonists, rhoA kinase inhibitors and Epac activators (Table 1). Other bronchodilator targets have met with limited clinical success (e.g. potassium channel openers) whereas others are currently in early preclinical investigation (e.g. natriuretic peptide receptor agonists). The discovery of biter taste receptors (TASR2) on airway smooth muscle might also offer the possibility of developing novel bronchodilators,[15] although whether nonbitter tasting bronchodilator molecules can be developed remains to be established.