pulmoПульмонологияPULMONOLOGIYA0869-01892541-9617Scientific and Practical Journal “PULMONOLOGIYA” LLC10.18093/0869-0189-2015-25-5-613-621pulmo-629Research ArticleОБЗОРЫREVIEWПолимодальные эффекты тиотропия бромида в терапии хронической обструктивной болезни легкихMultiple effects of tiotropium in chronic obstructive pulmonary diseaseКузубоваН. А.KuzubovaN. A.

д. м. н., зам. директора НИИ пульмонологии ГБОУ ВПО «Первый СанктПетербургский государственный медицинский университет им. акад. И.П.Павлова» Минздрава России; тел.: (812) 3386616

MD, Deputy Director, Research Pulmonology Institute, Academician I.P.Pavlov First SaintPetersburg State Medical University, Healthcare Ministry of Russia; tel.: (812) 3386616

kuzubova@mail.ruЛебедеваЕ. С.LebedevaE. S.

к. б. н., зав. лабораторией НИИ пульмонологии ГБОУ ВПО «Первый СанктПетербургский государственный медицинский университет им. акад. И.П.Павлова» Минздрава России; тел.: (812) 3387820

PhD in Biology, Head of Laboratory, Research Pulmonology Institute, Academician I.P.Pavlov First SaintPetersburg State Medical University, Healthcare Ministry of Russia; tel.: (812) 3387820

osmelena@mail.ruТитоваО. Н.TitovaO. N.

д. м. н., директор НИИ пульмонологии ГБОУ ВПО «Первый СанктПетербургский государственный медицинский университет им. акад. И.П.Павлова» Минздрава России; тел.: (812) 3386718

MD, Director of Research Pulmonology Institute, Academician I.P.Pavlov First SaintPetersburg State Medical University, Healthcare Ministry of Russia; tel.: (812) 3386718

titovaon@spbgmu.ruНИИ пульмонологии ГБОУ ВПО «Первый Санкт-Петербургский государственный медицинский университет им. акад. И.П.Павлова» Минздрава России: 197022, Санкт-Петербург, ул. Рентгена, 12РоссияResearch Pulmonology Institute, Academician I.P.Pavlov First Saint-Petersburg State Medical University, Healthcare Ministry of Russia: 12, Rentgena str., Saint-Petersburg, 197022, RussiaRussian Federation201513012016255613621Copyright © Кузубова Н.А., Лебедева Е.С., Титова О.Н., 20162016Кузубова Н.А., Лебедева Е.С., Титова О.Н.Kuzubova N.A., Lebedeva E.S., Titova O.N.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://journal.pulmonology.ru/pulm/article/view/629

Мхолинолитик длительного действия тиотропия бромид относится к лекарственным средствам первого выбора для пациентов с хронической обструктивной болезнью легких (ХОБЛ). Высокая эффективность тиотропия бромида в лечении больных ХОБЛ основана не только на блокировании парасимпатической холинергической бронхоконстрикции, но связана с его полимодальными эффектами не нейрональной природы. По результатам исследований последних лет доказана полимодальность тиотропия бромида, обусловленная его влиянием на Мрецепторопосредованные внутриклеточные сигнальные системы, участвующие в регуляции клеточномолекулярных взаимодействий, вовлеченных в процессы воспаления, пролиферации и ремоделинга легочных структур. Противовоспалительный, антипролиферативный, антиремоделирующий, противовирусный, антиоксидантный эффекты тиотропия бромида в сочетании с новым усовершенствованным устройством для его доставки (Респимат) определяют его преимущества перед другими длительно действующими антихонергическими препаратами и делают терапию пациентов с ХОБЛ более эффективной и безопасной.

Tiotropium is a longacting anticholinergic drug and the firstline therapy in patients with chronic obstructive pulmonary disease (COPD). High efficacy of tiotropium in COPD is based not only on inhibition of parasympathetic cholinergic bronchoconstriction, but also is associated with multiple nonneuronal effects. Recent studies demonstrated polymodality of tiotropium due to influence on Mreceptormediated intracellular signaling pathways participating in regulation of cellmolecular interactions involved in inflammation, proliferation, and remodeling of pulmonary structures. Antiinflammatory, antiproliferative, antiremodeling, antiviral, and antioxidant effects of tiotropium delivered via the new improved device Respimat determine advantages of this drug over other longacting anticholinergics and increase efficacy and safety of therapy in patients with COPD.

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The authors declare that there are no conflicts of interest present.