PT - JOURNAL ARTICLE AU - Reinoud Gosens AU - Nicholas Gross TI - The mode of action of anticholinergics in asthma AID - 10.1183/13993003.01247-2017 DP - 2018 Oct 01 TA - European Respiratory Journal PG - 1701247 VI - 52 IP - 4 4099 - http://erj.ersjournals.com/content/52/4/1701247.short 4100 - http://erj.ersjournals.com/content/52/4/1701247.full SO - Eur Respir J2018 Oct 01; 52 AB - Acetylcholine binds to muscarinic receptors to play a key role in the pathophysiology of asthma, leading to bronchoconstriction, increased mucus secretion, inflammation and airway remodelling. Anticholinergics are muscarinic receptor antagonists that are used in the treatment of chronic obstructive pulmonary disease and asthma. Recent in vivo and in vitro data have increased our understanding of how acetylcholine contributes to the disease manifestations of asthma, as well as elucidating the mechanism of action of anticholinergics. This review assesses the latest literature on acetylcholine in asthma pathophysiology, with a closer look at its role in airway inflammation and remodelling. New insights into the mechanism of action of anticholinergics, their effects on airway remodelling, and a review of the efficacy and safety of long-acting anticholinergics in asthma treatment will also be covered, including a summary of the latest clinical trial data.Pre-clinical data suggest that anticholinergics can reduce acetylcholine-induced airway inflammation and remodelling http://ow.ly/xqAQ30loP8F