Abstract

Conventional asthma and COPD treatments include the use of bronchodilators, mainly β2-adrenergic agonists, muscarinic receptor antagonists and corticosteroids or leukotriene antagonists as anti-inflammatory agents. These active drugs are administered either separately or given as a fixed-dose combination medication into a single inhaler. ASM-024, a homopiperazinium compound, derived from the structural modification of diphenylmethylpiperazinium (DMPP), has been developed to offer an alternative mechanism of action that could provide symptomatic control through combined anti-inflammatory and bronchodilator properties in a single entity. A dose-dependent inhibition of cellular inflammation in bronchoalveolar lavage fluid was observed in ovalbumin-sensitized mice, subsequently treated for 3 days by nose-only exposure with aerosolized ASM-024 at doses up to 3.8 mg/kg (ED50 = 0.03 mg/kg). The methacholine ED250 values indicated that airway hyperresponsivenness (AHR) to methacholine decreased following ASM-024 administration by inhalation at a dose of 1.5 mg/kg, with a value of 0.145±0.032 mg/kg for ASM 024-treated group as compared to 0.088±0.023 mg/kg for untreated mice. In in vitro isometric studies, ASM-024 elicited dose-dependent relaxation of isolated mouse tracheal, human, and dog bronchial preparations contracted with methacholine and guinea pig tracheas contracted with histamine. ASM-024 showed also a dose and time dependant protective effect on methacholine-induced contraction. Overall, with its combined anti-inflammatory, bronchodilating and bronchoprotective properties, ASM-024 may represent a new class of drugs with a novel pharmacological approach that could prove useful for the chronic maintenance treatment of asthma and, possibly, COPD.

Highlights

  • bronchoalveolar alveolar lavage (BAL) cell differential counts showed that all cell populations, including eosinophils, were decreased and that the relative percentages remained similar

  • This study was not designed to address the toxicology profile of ASM-024, the results show that this drug can induce significant pharmarcological activities relevant to asthma at doses that showed no evidence of toxicity either in in vivo or in vitro models

  • In the course of the clinical development of ASM-024, a comprehensive nonclinical safety program was conducted with ASM-024 in rats and dogs including safety pharmacology, toxicology, and genotoxicity studies

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Summary

Introduction

Asthma is a respiratory disease characterised by airway inflammation and hyperresponsiveness resulting in reversible bronchoconstriction that affects between 8 to 10% of the population in industrialised countries [1]. Current treatment is mostly based on inhaled corticosteroids and b2 receptor agonists used individually or in combination [2] Despite these effective treatments, half of asthmatics are not adequately controlled [3]. High doses and long term use of inhaled corticosteroids have been associated with significant and sometimes serious side effects [2]. Because of these unmet needs, the development of new treatments for asthma is warranted, especially for drugs that have a different mode of action, potentially bypassing the limitations of current medication [9]

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