Combined Beta-Agonists and Corticosteroids Do Not Inhibit Extracellular Matrix Protein Production In Vitro

Background . Persistent asthma is characterized by airway remodeling. Whereas we have previously shown that neither β 2 -agonists nor corticosteroids inhibit extracellular matrix (ECM) protein release from airway smooth muscle (ASM) cells, the effect of their combination is unknown and this forms the rationale for the present study. Methods . ASM cells from people with and without asthma were stimulated with TGF β 1 (1 ng/ml) with or without budesonide (10 −8  M) and formoterol (10 −10 and 10 −8  M), and fibronectin expression and IL-6 release were measured by ELISA. Bronchial rings from nonasthmatic individuals were incubated with TGF β 1 (1 ng/ml) with or without the drugs, and fibronectin expression was measured using immunohistochemistry. Results . Budesonide stimulated fibronectin deposition, in the presence or absence of TGF β 1, and this was partially reversed by formoterol (10 −8  M) in both asthmatic and nonasthmatic cells. Budesonide and formoterol in combination failed to inhibit TGF β -induced fibronectin in either cell type. A similar pattern of expression of fibronectin was seen in bronchial rings. TGF β 1-induced IL-6 release was inhibited by the combination of drugs. Conclusion . Current combination asthma therapies are unable to prevent or reverse remodeling events regulated by ASM cells.