β-Adrenergic receptor agonist bronchodilators in the treatment of COPD

After smoking cessation, bronchodilators are first-line therapy in the treatment of chronic obstructive pulmonary disease (COPD) [1]. Among the bronchodilators currently available, selective h-adrenergic receptor agonists have been extensively used over the last 30 years. An interesting paradox is that lack of response to h-agonists has often been used to define patients with COPD, particularly in clinical trials. This has often led to a general impression that treatment of COPD offers little benefit. Available data, however, clearly demonstrate that the majority of COPD patients respond to bronchodilators, including h-agonists [2,3]. Moreover, evidence is accumulating that h-agonists may benefit patients by mechanisms different from simple bronchodilatation. This chapter will review the current understanding of h-agonist bronchodilators and their role in the treatment of COPD.