We aimed to explore whether the acute bronchodilation induced by indacaterol 150 μg and glycopyrronium bromide 50 μg is additive or synergistic with respect to monocomponents by testing the type of effect ex vivo on isolated human bronchi and then in vivo in COPD patients. Both indacaterol and glycopyrronium caused a concentration-dependent relaxation of human isolated bronchial tissues sub-maximally pre-contracted with acetylcholine; glycopyrronium was significantly more potent than indacaterol. The analysis of data using the Bliss Independence (BI) criterion indicated that glycopyrronium plus indacaterol produced an additive interaction at the isoeffective concentrations inducing EC20 and a significant synergistic relaxant effect at isoeffective concentrations inducing EC30. In COPD patients, the inhalation of indacaterol and glycopyrronium in combination significantly anticipated at 15 min post-administration the mean peak of bronchodilatory effect compared to the two drugs administered alone. The study of interaction between indacaterol and glycopyrronium by BI analysis evidenced an additive effect for FEV1 between 5 min and 180 min post-inhalation, with synergistic interaction at 15 min post-administration, compared to the bronchodilation induced by these drugs administered alone. This study suggests that the combination ensures a broncholytic effect that is greater than that induced by the single monocomponents.

译文

:我们的目的是通过测试离体人支气管的体外作用类型,然后对COPD患者进行体内作用,来研究150克茚达特罗和50克格隆溴铵引起的急性支气管扩张相对于单组分是否具有累加性或协同作用。茚达特罗和格隆铵都引起人体分离的支气管组织的浓度依赖性松弛,该组织最大程度地被乙酰胆碱预收缩。格隆溴铵比茚达特罗明显更有效。使用极乐独立性(BI)标准进行的数据分析表明,格隆铵加茚达特罗在诱导EC20的等效浓度下产生加性相互作用,在诱导EC30的等效浓度下产生显着的协同松弛作用。与单独使用两种药物相比,在COPD患者中,联合使用茚达特罗和格隆溴铵后15分钟的吸入明显达到了支气管扩张作用的平均峰值。通过BI分析对茚达特罗与格隆铵之间相互作用的研究表明,与单独使用这些药物诱导的支气管扩张相比,吸入后5分钟至180分钟之间FEV1具有累加效应,在给药后15分钟具有协同相互作用。这项研究表明,这种组合可确保支气管扩张作用大于单一单组分诱导的支气管扩张作用。

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