Smoking, Flu Decrease Efficacy of COPD Medications

Chronic obstructive pulmonary disease (COPD) medication is less effective in patients with COPD who smoke and have had exposure to respiratory viruses, according to a new study.

Respiratory viruses such as influenza A decrease the efficacy of β₂-adrenoceptor agonists during acute exacerbations of COPD. This prompted the researchers to further study the effects of β₂-adrenoceptor agonists—specifically salbutamol, a common COPD treatment—on small airway reactivity.
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To conduct their study, the researchers analyzed precision-cut lung slices from a cigarette-smoke–exposed mouse model, which was also exposed to the influenza A virus.

At baseline, when the mice had only been exposed to cigarette smoke, the researchers found that salbutamol was less potent and less effective.

After the mice were injected with influenza A virus, the responses to salbutamol were transient and not well maintained.

“The present study has shown decreased sensitivity to [salbutamol] after cigarette smoking, or a combination of cigarette smoking and [influenza] occurs by different mechanisms,” the researchers concluded. “In addition, the [precision cut lung slices] technique and our models of [cigarette smoke] and influenza infection provide a novel setting for assessment of alternative bronchodilators.”

—Amanda Balbi

Reference:

Donovan C, Seow HJ, Bourke JE, Vlahos R. Influenza A virus infection and cigarette smoke impair bronchodilator responsiveness to β-adrenoceptor agonists in mouse lung [published April 10, 2016]. Clin Med. doi:10.1042/CS20160093.