Prospects for bronchodilating drugs in the 1990s

There is likely to be a continuing need for bronchodilator drugs until the time that the primary underlying defect in asthma is determined. At the moment there are several interesting and exciting developments both in the areas of well established drugs (beta agonists, antimuscarinic drugs and phosphodiesterase inhibitors) and in new areas. The potassium channel activators are clearly of interest; more information on their therapeutic ratio is needed. It may be that antagonists or inhibitors of leukotrienes or PAF will find a role and there should be some answers shortly from the studies that are currently underway. Opioid analogues may have a place though at present they must be regarded as rather speculative. Greater understanding of cell signal transduction should provide a further opportunity to modulate smooth muscle contraction and the function of other cells relevant to asthma.