Long-acting beta-agonists and exercise

摘要

Since the first reported use of "adrenal substance" for acute asthma in 1900, adrenergic receptor agonists have long been the agents of choice for relieving acute symptoms of asthma. Considerable pharmacologic research has subsequently gone into the development of variations of these receptor agonists, resulting in agents with more specific targeting of the beta_2-adrenergic receptor and much longer duration of action. Salmeterol and formoterol are the currently available longest-acting beta_2-agonists, commonly abbreviated as LABAs, although even longer-acting ones have been developed for anticipated marketing. The primary established role for a LABA is as additive maintenance therapy to inhaled corticosteroids.It is as daily maintenance therapy that LABAs have generated controversy and led to the current "black-box" warning associated with salmeterol and formoterol.In addition to providing acute bronchodilatation to relieve acute symptoms of asthma, inhaled beta_2-adrenergic receptor agonists have been used as highly effective prophylaxis for exercise-induced asthma. Like their shorter-acting predecessors, LABAs also have bronchoprotective effects for exercise-induced bronchospasm. The purpose of this editorial is to examine their role with regard to exercise.