Effects of ( R,R)- and ( R,R/S,S)-Formoterol on Airway Relaxation and Contraction in an Experimental Rat Model

Abstract

Background: Racemic ( R,R/S,S)-formoterol is a long-acting β-agonist composed of a 50:50 mixture of ( R,R)- and ( S,S)-enantiomers. Objective: The aim of this study was to determine whether ( R,R)-formoterol and ( R,R/S,S)-formoterol have differing effects on airway contraction and relaxation in vitro. Methods: Cylindrical airway segments 3-mm long were isolated from the mid-trachea of healthy Sprague-Dawley rats and placed in a modified Krebs-Henseleit solution. Dose-response curves of bethanechol-induced contraction (measured as milligrams of tension) and the concentration of bethanechol that elicited 50% to 75% of maximal contraction (EC 50–75) were determined. The air-way cylinders were then precontracted with bethanechol at the EC 50–75 and exposed to different concentrations of ( R,R)-formoterol (0.0001–1.0 μM) or ( R,R/S,S)-formoterol (0.0002–2.0 μM). Each concentration of the 2 formoterol formulations contained the same amount of ( R,R)-enantiomer (eg, [ R,R]-formoterol 0.0001 μM and [ R,R/S,S]-formoterol 0.0002 1JM contained the same amount of [ R,R]-enantiomer). The relaxation percentage in response to formoterol was calculated as a reduction in tension (in milligrams) in relation to baseline tension in the precontracted state, with each tracheal cylinder serving as its own control. To determine the effect of ( R,R)-formoterol on airway contraction, tracheal cylinders were incubated with ( R,R)- or ( R,R/S,S)-formoterol before electrical field stimulation (EFS). Results: Tracheae from 56 three-week-old Sprague-Dawley rats were used in the study. The relaxation percentage of precontracted trachea was significantly greater after exposure to ( R,R)-formoterol than to ( R,R/S,S)-formoterol at a 2-fold higher concentration ( P = 0.03; general linear model with repeated measures analysis comparing the 2 groups of animals). However, in a post hoc analysis, the mean (SE) relaxation percentage of precontracted trachea was significantly greater only after exposure to ( R,R)-formoterol 0.01 μM than to ( R,R/S,S)-formoterol 0.02 μM (15.6% [5.8%] vs 39.0% [5.6%]; P < 0.05, unpaired t test). EFS-induced airway contraction was significantly less in tracheal cylinders incubated in ( R,R)-formoterol compared with those incubated in ( R,R/S,S)-formoterol at a 2-fold higher concentration ( P = 0.05; general linear model with repeated measures analysis comparing the 2 groups of animals). However, in the post hoc analysis, mean (SE) EFS-induced tracheal contraction was significantly less only in ( R,R)-formoterol 0.01 μM compared with ( R,R/S,S)-formoterol 0.02 μM at 10 V (1070 [55] mgvs 1225 [28] mg; P < 0.05, unpaired t test). Conclusion: We found that ( R,R)-formoterol may induce greater relaxation of precontracted airway smooth muscle cells than ( R,R/S,S)-formoterol and that ( R,R)-formoterol may have a greater inhibitory effect on the endogenous cholinergic and excitatory nonadrenergic, noncholinergic contractile airway responses than ( R,R/S,S)-formoterol. We speculate that the presence of the ( S,S)-enantiomer in ( R,R/S,S)-formoterol may impair airway relaxation of pre-contracted trachea in rats.