[New development of pharmacotherapy--physiological basis and future possibility]

In COPD management, currently available treatments improve the quality of life (QOL) of the patients. According to the international and Japanese guidelines, long-acting bronchodilators are central to the management of COPD. Recently developed long-acting anti -cholinergic agent and beta2-agonists show remarkable effects on COPD subjects compared with short-acting agents. The physiological explanation of the efficacy of long-acting bronchodilators seems to be due to the pharmacological volume reduction via airway dilation. In future, we need COPD specific anti-inflammatory agents, including histone deacetylase (HDAC) activator.