Pharmacology and Therapeutics of Airway Disease, Second Edition, Volume 234 (Lung Biology in Health and Disease)

470 Pages·2009·6.02 MB·English

by  Kian Fan Chung

Pulmonary Medicine Volume Lung Biology in Health and Disease Volume 234
234
Executive Editor: Claude Lenfant
about the book…
Written by 27 experts at the forefront of airway disease management, this groundbreaking
text offers respiratory physicians, investigators, and allied professionals state-of-the-art Pharmacology
therapies and management strategies for preventing and treating advanced respiratory
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test new treatments, gives readers the most cutting-edge therapies for improving Ew
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• e vidence-based data—derived from clinical trials in asthma and chronic obstructive iac
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pulmonary disease, as well as the editors’ experiences with airway disease, provides ioyo of Airway Disease
clinicians with concrete, clinically oriented information they can trust n Dlo
• e ssential background information—a comprehensive review of the normal and
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abnormal physiologic, biochemical, and molecular aspects of the respiratory tract s
provide physicians with the information they need to understand the history and ey
Second Edition
pathophysiology of respiratory tract diseases a a
• c omplication management strategies—expert advice on how to control sn
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inflammation and reverse or prevent airflow obstruction helps clinicians foresee, d
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about the editors...
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KIAN FAN CHUNG is Professor of Respiratory Medicine and Head of the Experimental
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Studies Section, National Heart and Lung Institute, Imperial College, and Consultant
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Physician, Royal Brompton & Harefield NHS Trust, London, UK. Dr. Chung received his a
M.D. from the University of London, London, UK. He is a member of numerous professional p
societies, including the American Thoracic Society and the European Respiratory Society. e
Dr. Chung is also Co-Editor-in-Chief of Cough and serves on the editorial boards of several u
other notable journals, such as Respiration, Respirology, Allergy, and European Journal of t
Pharmacology. He is Editor of 11 books, including Informa Healthcare’s Pharmacology of the i
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Respiratory Tract: Experimental and Clinical Research. He has co-authored over 400 original s
manuscripts on respiratory medicine and science.
PETER J. BARNES is Professor of Thoracic Medicine and Head of Airway Disease, the National
Heart and Lung Institute, and Honorary Consultant Physician, Royal Brompton Hospital,
London, UK. He is a Fellow of the Academy of Medical Sciences and serves on the editorial
boards of several prestigious journals. Listed as one of the world’s top 50 most cited
scientists according to the journal Science Watch, Dr. Barnes is also Author of more than 40
Chung
books, including Informa Healthcare’s An Atlas of Chronic Obstructive Pulmonary Disease
and Chronic Obstructive Pulmonary Disease: Cellular and Molecular Mechanisms. •
Barnes
Printed in the United States of America
H7000 edited by
Kian Fan Chung
Peter J. Barnes
Pharmacology
and Therapeutics
of Airway Disease
LUNG BIOLOGY IN HEALTH AND DISEASE
Executive Editor
Claude Lenfant
FormerDirector,NationalHeart,Lung,andBloodInstitute
NationalInstitutesofHealth
Bethesda,Maryland
1. ImmunologicandInfectiousReactionsintheLung,editedbyC.H.Kirkpatrick
andH. Y. Reynolds
2. TheBiochemical Basisof PulmonaryFunction, editedbyR. G.Crystal
3. BioengineeringAspectsof the Lung,editedbyJ.B. West
4. MetabolicFunctionsof the Lung,editedbyY. S.Bakhle andJ. R. Vane
5. RespiratoryDefenseMechanisms(intwo parts),editedbyJ. D.Brain,
D.F. Proctor,and L.M.Reid
6. Developmentofthe Lung,editedbyW.A. Hodson
7. LungWater andSolute Exchange,editedbyN. C.Staub
8. ExtrapulmonaryManifestationsofRespiratoryDisease,editedbyE.D.Robin
9. ChronicObstructive PulmonaryDisease, editedbyT.L. Petty
10. Pathogenesisand Therapyof LungCancer,editedbyC. C. Harris
11. GeneticDeterminants ofPulmonary Disease,editedbyS. D. Litwin
12. TheLungin theTransition BetweenHealth andDisease, editedby
P.T. Macklemand S.Permutt
13. Evolution ofRespiratoryProcesses: AComparativeApproach, editedby
S.C. Woodand C. Lenfant
14. PulmonaryVascularDiseases, editedbyK. M.Moser
15. Physiologyand Pharmacologyofthe Airways, editedbyJ. A.Nadel
16. DiagnosticTechniquesin PulmonaryDisease(in twoparts), editedby
M.A.Sackner
17. Regulationof Breathing(in twoparts),editedbyT. F.Hornbein
18. OccupationalLungDiseases: ResearchApproaches and Methods,editedby
H.Weill and M.Turner-Warwick
19. Immunopharmacologyof the Lung,editedbyH. H. Newball
20. Sarcoidosisand OtherGranulomatous Diseasesofthe Lung,editedby
B.L. Fanburg
21. Sleepand Breathing, editedbyN. A.Saunders andC. E. Sullivan
22. Pneumocystiscarinii Pneumonia: Pathogenesis,Diagnosis, andTreatment,
editedbyL.S. Young
23. PulmonaryNuclear Medicine:Techniquesin Diagnosis ofLungDisease,
editedbyH.L. Atkins
24. AcuteRespiratoryFailure, editedbyW.M.Zapol andK. J.FaIke
For information on volumes 25–182 in the Lung Biology in Health and
Disease series, please visit www.informahealthcare.com
183. AcuteExacerbations ofChronic ObstructivePulmonary Disease,editedby
N.M.Siafakas, N. R. Anthonisen,and D. Georgopoulos
184. LungVolume Reduction Surgeryfor Emphysema,editedbyH. E.Fessler,
J.J.Reilly, Jr.,and D. J.Sugarbaker
185. IdiopathicPulmonaryFibrosis, editedbyJ. P.Lynch III
186. PleuralDisease, editedbyD. Bouros
187. Oxygen/NitrogenRadicals: LungInjuryand Disease,editedbyV. Vallyathan,
V.Castranova, andX. Shi
188. Therapyfor Mucus-ClearanceDisorders, editedbyB. K.Rubin and
C.P. vanderSchans
189. InterventionalPulmonaryMedicine,editedbyJ.F.Beamis, Jr.,P.N.Mathur,
andA. C. Mehta
190. LungDevelopment andRegeneration, editedbyD. J.Massaro, G. Massaro,
andP. Chambon
191. Long-TermInterventionin Chronic ObstructivePulmonary Disease,editedby
R.Pauwels, D. S. Postma,and S.T. Weiss
192. SleepDeprivation: BasicScience,Physiology,and Behavior,editedbyClete
A.Kushida
193. SleepDeprivation: ClinicalIssues, Pharmacology,and Sleep LossEffects,
editedbyClete A.Kushida
194. PneumocystisPneumonia: Third Edition, RevisedandExpanded, editedby
P.D. Walzer andM.Cushion
195. AsthmaPrevention,editedbyWilliamW.BusseandRobertF.Lemanske,Jr.
196. LungInjury:Mechanisms,Pathophysiology,andTherapy,editedbyRobertH.
Notter,JacobFinkelstein, and BruceHolm
197. IonChannels inthe Pulmonary Vasculature, editedbyJasonX.-J. Yuan
198. ChronicObstructivePulmonaryDisease:CellularandMolecularMechanisms,
editedbyPeter J.Barnes
199. PediatricNasalandSinusDisorders,editedbyTaniaSihandPeterA.R.Clement
200. Functional LungImaging,editedbyDavidLipson and Edwin vanBeek
201. LungSurfactant Functionand Disorder, editedbyKaushikNag
202. PharmacologyandPathophysiology ofthe Control ofBreathing, editedby
DenhamS.Ward, AlbertDahan,and LucJ. Teppema
203. MolecularImagingoftheLungs,editedbyDanielSchusterandTimothyBlackwell
204. AirPollutantsand the RespiratoryTract: SecondEdition, editedby
W.MichaelFoster and DanielL. Costa
205. AcuteandChronicCough,editedbyAnthonyE.RedingtonandAlynH.Morice
206. SeverePneumonia, editedbyMichael S.Niederman
207. MonitoringAsthma,editedbyPeter G. Gibson
208. Dyspnea:Mechanisms,Measurement, and Management,Second Edition,
editedbyDonaldA.Mahler and DenisE. O’Donnell
209. ChildhoodAsthma,editedbyStanley J.Szeflerand SfrenPedersen
210. Sarcoidosis,editedbyRobert Baughman
211. TropicalLungDisease, SecondEdition,editedbyOmSharma
212. PharmacotherapyofAsthma, editedbyJamesT.Li
213. PracticalPulmonaryandCriticalCareMedicine:RespiratoryFailure,editedby
ZabMosenifar andGuy W.Soo Hoo
214. PracticalPulmonaryandCriticalCareMedicine:DiseaseManagement,edited
byZabMosenifar andGuy W.Soo Hoo
215. Ventilator-InducedLungInjury, editedbyDidier Dreyfuss, GeorgesSaumon,
andRolf D. Hubmayr
216. Bronchial Vascular Remodeling in Asthma and COPD, edited by Aili Lazaar
217. LungandHeart–LungTransplantation,editedbyJosephP.LynchIIIandDavid
J.Ross
218. GeneticsofAsthmaand Chronic ObstructivePulmonary Disease,editedby
DirkjeS. PostmaandScott T.Weiss
219. Reichman andHershfield’s Tuberculosis: AComprehensive,International
Approach,Third Edition (intwoparts), editedbyMario C.Raviglione
220. NarcolepsyandHypersomnia,editedbyClaudioBassetti,MichelBilliard,and
EmmanuelMignot
221. InhalationAerosols: Physicaland Biological BasisforTherapy,Second
Edition, editedbyAnthony J.Hickey
222. ClinicalManagement ofChronic ObstructivePulmonary Disease,Second
Edition, edited by Stephen I. Rennard, Roberto Rodriguez-Roisin, Ge´rard
Huchon,andNicolas Roche
223. Sleepin Children, SecondEdition: Developmental Changesin Sleep
Patterns,editedbyCaroleL.Marcus,JohnL.Carroll,DavidF.Donnelly,and
GeraldM.Loughlin
224. Sleepand Breathingin Children, SecondEdition: Developmental Changesin
BreathingDuringSleep,editedbyCaroleL.Marcus,JohnL.Carroll,DavidF.
Donnelly,andGerald M.Loughlin
225. VentilatorySupportforChronic RespiratoryFailure, editedbyNicolino
Ambrosinoand RogerS.Goldstein
226. DiagnosticPulmonaryPathology, SecondEdition,editedbyPhilip T.Cagle,
TimothyC. Allen,and MaryBeth Beasley
227. InterstitialPulmonaryandBronchiolarDisorders,editedbyJosephP.LynchIII
228. ChronicObstructivePulmonaryDiseaseExacerbations,editedbyJadwigaA.
Wedzichaand FernandoJ.Martinez
229. PleuralDisease, SecondEdition,editedby DemosthenesBouros
230. InterventionalPulmonaryMedicine,SecondEdition,editedbyJohnF.Beamis,
Jr.,PraveenMathur,and AtulC. Mehta
231. SleepApnea: Implicationsin Cardiovascular and CerebrovascularDisease,
SecondEdition, editedbyDouglasT. Bradleyand JohnFloras
232. RespiratoryInfections,editedbySanjay Sethi
233. AcuteRespiratoryDistress Syndrome,editedbyAugustine M.K.Choi
234. PharmacologyandTherapeuticsofAirwayDisease,SecondEditioneditedby
KianFanChung and PeterJ. Barnes
The opinions expressed in these volumes do not necessarily represent the views of
the National Institutes of Health.
Pharmacology
and Therapeutics
of Airway Disease
Second Edition
edited by
Kian Fan Chung
National Heart and Lung Institute
Imperial College

London, UK
Peter J. Barnes
National Heart and Lung Institute
Imperial College
London, UK
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LibraryofCongressCataloging-in-PublicationData
Pharmacologyandtherapeuticsofairwaydisease/editedbyKianFanChung,Peter
J.Barnes.–2nded.
p.;cm.–(Lungbiologyinhealthanddisease;v.234)
Rev.ed.of:Pharmacologyoftherespiratorytract/editedbyK.FanChung,
PeterJ.Barnes.c1993.
Includesbibliographicalreferencesandindex.
ISBN-13:978-1-4200-7000-2(hardcover:alk.paper)
ISBN-10:1-4200-7000-2(hardcover:alk.paper) 1. Respiratoryorgans—
Pathophysiology.2. Respiratoryorgans—Effectofdrugson.3. Respiratory
organs—Diseases—Molecularaspects. I.Chung,K.Fan,1951-II.Barnes,
PeterJ.,1946-III.Pharmacologyoftherespiratorytract.IV.Series:Lungbiology
inhealthanddisease;v.234.
[DNLM:1. LungDiseases,Obstructive—drugtherapy.2. Anti-Asthmatic
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Introduction
In1993, volume67,PharmacologyoftheRespiratory Tract,appearedaspart of
this series of monographs Lung Biology in Health and Disease. In the preface,
the editors, K. Fan Chung and Peter J. Barnes, indicated that the volume
combined two concepts and stated “one deals with basic mechanisms of cell
activationandpathophysiology,andtheotherwithseveralfunctionalaspectsof
specific cell types found in the normal and abnormal respiratory tract.”
There is no doubt that volume 67 opened the window to a new world of
research on the treatment of airway dysfunctions and pathological alterations.
This expose of new knowledge significantly departed from what had been
investigated for decades before, relative to the treatment of asthma, chronic
bronchitis, and emphysema.
New hypotheses presented in volume 67 stimulated many investigations
adding knowledge at a pace never seen before in research of the respiratory
tract with regard to asthma and chronic obstructive pulmonary disease, or
COPD—thetermthatisnowwidelyused;thisseriesofmonographsbecamean
important vehicle for the transfer of new advances. In fact, 31 monographs
about asthma, 12 about COPD, and 13 that cover both conditions have
appeared since 1993—and more are in preparation!
Thisnewvolume,alsoeditedbyK.FanChungandPeterJ.Barnes,hasa
differenttitlefromthatoftheirfirstmonograph,PharmacologyandTherapeutics
ofAirway Disease.This isbecause a new arrayoftherapeutic approaches often
derived from very basic research advances can be described and are utilized
clinically. Many alter the natural history of asthma and COPD, and more
importantly,haveconsiderablyimprovedthequalityoflifeforpatientswhoare
diagnosed with these airways diseases.
In the preface of this new volume, the editors state, “This volume is
addressed to respiratory physicians, respiratory investigators, and respiratory
alliedprofessionals,”thereaderswhohavethemostopportunitytoprovidehelp
to the patients. Thus, it is a privilege to introduce this new volume. As the
executiveeditorofthisseriesofmonographs,Ithanktheeditorsandtheauthors
for the opportunity to present it to our readership.
ClaudeLenfant,MD
Vancouver,Washington,U.S.A.
vii

Preface
Since the publication of the first edition, there have been many significant
advances in the pharmacology and therapeutics of the respiratory tract. This
has been evident by the introduction of a number of new entities in the
treatment of many respiratory tract diseases. In parallel, there have been
advances in the assessment and evaluation of new drugs, and in understanding
of the pathophysiology of respiratory tract diseases and of the methods of
measuring airway and clinical responses such that potential targets for therapy
have been identified and are being investigated, together with new therapeutic
uses of already-available drugs.
Airway diseases comprise asthma and chronic obstructive pulmonary
disease (COPD), which cause much chronic respiratory disability and death
in the world. They are characterized by intermittent and/or chronic airflow
obstruction, which in severe asthma and COPD can be poorly responsive to
available treatments. Themorbidity andmortality caused bythese diseasesare
increasing,inparticularCOPD, which is nowthesixth most commoncause of
deathworldwidebutpredictedtobecomethethirdcommonestcausewithinthe
next 10 years. There is therefore a pressing need to obtain even more effective
treatments than that we currently have.
This volume is addressed to the respiratory physician, respiratory inves-
tigators,andrespiratoryalliedprofessions.Itnotonlyprovidestheconceptsupon
which many treatments are used for these conditions, but also emphasizes the
wayinwhichthesetreatmentswork,andhownewtreatmentscanbediscovered
and tested in different patient groups. The book focuses on the state-of-the-art
pharmacologic and therapeutic approaches in controlling pathophysiological
processes in the airways, and reviews normal and abnormal physiologic, bio-
chemical, and molecular aspects of the respiratory tract. It explores the basic
mechanismsofinflammatorycellactivationandpathophysiologyindisease,and
therapeutic ways of controlling inflammation, ways of reversing or preventing
airflow obstruction, and symptomatic treatments for advanced disease.
ix