Can We Find Better Bronchodilators to Relieve Asthma Symptoms?

Table 1

Summary of benefits and limitations of novel bronchodilators.

Drug class	Benefits	Limitations
𝛽-agonists	Rapid airway relaxation; Selective for 𝛽2-AR; decreased systemic effects	Receptor desensitization; Receptor downregulation; Refractory bronchoconstriction; Asthma-related death
PDE inhibitors	Increase cAMP generated endogenously; Enhance 𝛽2-AR effects; Selectivity for subtypes specific to lung	Oral delivery; Complex dosing and metabolism; Systemic side effects; Potential adenylyl cyclase and/or 𝛽2-AR desensitization
Phytotherapeutics	Airway relaxation; Acute and chronic effects; Reduces inflammation and remodeling; Increased patient compliance	Mechanisms of action are not clearly defined; Potential interaction with other drugs; Difficulty standardizing source and dosing
Bitter tastants	Novel target—may augment traditional therapies due to cAMP-independence	Mechanisms of action are not clearly defined
Chloride channel modulators	Novel target—may augment traditional therapies; May address neuronal components of airway tone	Mechanisms of action are not clearly defined; Method of delivery; Interaction with airway epithelium (mucous production); Systemic side effects