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Salbutamol Function and Effects in Asthma and Parkinson’s Disease

Updated on September 5, 2017
AliciaC profile image

Linda Crampton is a teacher with a first class honors degree in biology. She writes about human biology and the scientific basis of disease.

A typical salbutamol, albuterol, or Ventolin inhaler
A typical salbutamol, albuterol, or Ventolin inhaler | Source

Salbutamol in Rescue or Reliever Inhalers

Salbutamol (also known as albuterol) is an inhaled medication that is prescribed to open up the airways during an asthma attack. It's also used in COPD, or chronic obstructive pulmonary disease. A common brand name of the medication is Ventolin. Salbutamol can be a vital treatment when breathing becomes difficult. The chemical’s benefits may extend beyond the respiratory system, however. A research team at the Harvard Medical School has discovered that salbutamol intake appears to reduce the risk of Parkinson’s disease development.

Salbutamol is traditionally delivered from a blue inhaler, which is sometimes called a rescue or a reliever inhaler. The medication is contained in a canister. The top of the canister must be pressed in order the release the drug in aerosol form through the mouthpiece of the inhaler.

Using a salbutamol inhaler
Using a salbutamol inhaler | Source

What Is Asthma?

Asthma is a chronic disorder in which the airways in the respiratory system are inflamed. The airways are the passageways that transport air to the alveoli, or air sacs, in the lungs. The trachea or windpipe is the widest airway. It leads to a tube called a bronchus (plural: bronchi) in each lung. Each bronchus branches into narrower bronchi, which in turn branch into tiny bronchioles. The bronchioles send inhaled air to the alveoli. Here oxygen enters the bloodstream. Carbon dioxide leaves the blood and enters the alveoli to be exhaled.

When inflammation flares up during an asthma attack, the tissue lining the airways swells. This obstructs the passage of air. In addition, glands in the tissue make an excessive amount of mucus, which collects in the airway. There is another problem that develops during an asthma attack which makes breathing even harder. The muscles around the outside of the airways tighten, making it difficult for the airways to expand so that they can transport more oxygen.

A severe asthma attack can be life threatening and may require emergency medical treatment. Most people develop at least some degree of control over their symptoms with appropriate medications and the avoidance of their personal triggers for asthma attacks. The goal of treatment is to find a regimen that eliminates the attacks. My personal regimen controls my asthma well, but occasionally I need to use my salbutamol inhaler. At the moment, the condition can be treated but not cured.

The airways are the trachea, bronchi, and bronchioles.
The airways are the trachea, bronchi, and bronchioles. | Source

Asthmatics often use a maintenance inhaler containing a corticosteroid every day in order to reduce inflammation in their airways. This decreases the chance of an asthma attack and the need to use the rescue inhaler.

Asthma Facts From TED-Ed

How Does Salbutamol Relieve Asthma?

Salbutamol is classified as a beta-2 adrenergic receptor agonist. A receptor is a protein on or in the cell membrane that binds to specific chemicals that come into contact with the cell. As a result of the union, the receptor is activated and a particular process is triggered. An agonist is a chemical that activates a receptor. Adrenergic receptors got their name because they are stimulated by epinephrine, which is also known as adrenaline.

The ability of salbutamol to activate the beta-2 type of adrenergic receptor is the basis of its benefits in asthma, COPD, and possibly in Parkinson’s disease as well. The receptor is also known as a β2-adrenoreceptor or as β2AR. It's common in the muscles around the airways. Salbutamol's activation of the receptor leads to relaxation of the muscles and widening of the airways.

A beta-2 adrenergic receptor in the cell membrane
A beta-2 adrenergic receptor in the cell membrane | Source

A cell membrane contains two rows of phospholipid molecules, which are the orange structures in the simplified illustration of a membrane shown above. The green structure is the receptor. Like other proteins, it has a highly folded structure.

What Is Parkinson's Disease?

Parkinson's disease is a neurodegenerative condition. A characteristic of the disease is the collection of tangled fibres of a protein called alpha-synuclein in the brain. The tangles join to other substances to form structures called Lewy bodies. These bodies appear mainly in a region of the brain known as the substantia nigra.

Brain cells in the substantia nigra die when Lewy bodies are present. The living cells make a neurotransmitter called dopamine. A neurotransmitter is a substance that influences the passage of nerve impulses from one neuron (nerve cell) to another. Dopamine is involved in a variety of processes in the body, including the control of movement. Loss of dopamine leads to movement problems, balance problems, and muscle tremors in people with Parkinson's disease. The disease can't be cured at the moment, but it can be helped by a variety of treatments.

It's not completely clear whether tangled alpha-synuclein is the cause of Parkinson's disease or the result, but many researchers seem to feel that it's more likely to be the cause. Scientists have been searching for a way to break Lewy bodies down or to trigger the body to get rid of them. The Harvard researchers decided to look for a way to reduce the amount of alpha-synuclein that's made instead. The protein is a normal component of our nervous system, so it mustn't be completely eliminated.

In Parkinson's disease, cells in the substantia nigra die.
In Parkinson's disease, cells in the substantia nigra die. | Source

Individuals who inhaled the highest doses of salbutamol were about half as likely to develop the devastating neurological condition as those who didn’t take the drug.

— Mitch Leslie, Science (an AAAS publication)

Salbutamol and Parkinson's Disease Risk

The interesting and perhaps very significant research linking salbutamol to Parkinson's disease reduction was performed at the Harvard Medical School in Boston. In the first stage of the research, the scientists grew human nerve cells in the lab. They then tested more than 1100 chemicals to see if they reduced the amount of alpha-synuclein that was produced by the cells. The chemicals that were tested included dietary supplements, herbal compounds, and medications.

Several activators of β2-adrenoreceptors were found to be effective at reducing the alpha-synuclein level, including salbutamol. A hypertension drug named propranolol increased the amount of alpha-synuclein, however. This fact may be significant because the drug inhibits the activity of β2-adrenoreceptors. Inhibitors of receptors are called antagonists.

In the second stage of the research, the scientists examined a large Norwegian database with the aid of a scientist from the University of Bergen. The database contained the prescription records of 4.6 million people. The researchers analyzed the records of people who had been prescribed salbutamol during a period of eleven years (2004 to 2014). The identity of the people wasn't revealed. Results varied based on how often a patient was prescribed the medication, but overall the researchers found that a person taking salbutamol was one third less likely to develop Parkinson's disease during the eleven years of the study.

Structure of the two slightly different forms of salbutamol; carbon atoms are black, hydrogen white, oxygen red, and nitrogen blue
Structure of the two slightly different forms of salbutamol; carbon atoms are black, hydrogen white, oxygen red, and nitrogen blue | Source

People mustn't take extra salbutamol in an attempt to prevent Parkinson's disease. The drug can have potentially serious side effects if it's taken in excess. It's also important that people continue to take prescribed medicines known as beta-blockers. These stop certain chemicals from binding to beta-2 adrenergic receptors.

How May Salbutamol Reduce the Risk of Parkinson's Disease?

The research into how salbutamol influences the risk of Parkinson's disease is still in its very early stages. One possible clue has been discovered. It may or may not apply to salbutamol. It was discovered by testing a different bronchodilator and β2-adrenoreceptor agonist (clenbuterol). This was one of the successul chemicals in the first stage of the Harvard research.

The Harvard researchers used mouse cells and isolated human cells in their study. They found that when β2-adrenoreceptors in the cells were activated by clenbuterol, the gene containing instructions for making alpha-synuclein was inhibited. Genes are located in our DNA (deoxyribonucleic acid), which is in turn located in the nucleus of the cell. They contain the code for making proteins.

What Is a Clinical Trial?

Caution is Needed When Interpreting Results of Surveys

The results of the Harvard survey are fascinating and potentially very important. A survey can't prove that a chemical has a health benefit, however, although it can suggest that this is possible or even likely. The larger the database that is studied, the more likely that the conclusions are true. A clinical trial is necessary to demonstrate that a discovery is correct. In this type of experiment, a treatment is administered to volunteers under conditions that are as much as possible controlled. The effects of the treatment are then studied in detail.

Some points to consider when analyzing the Harvard research include the following:

  • The people in the Harvard and Norwegian survey who appeared to have been helped by salbutamol may actually have benefited due to a factor that is sometimes linked with salbutamol use and not from the medication itself.
  • It's possible that people need a certain gene variant or variants before they can benefit from salbutamol's effect on Parkinson's development.
  • People in countries in which people have a different lifestyle and gene variant frequency from Norwegians may show different results.
  • Some people who were free of Parkinson's during the eleven-year-study may have developed the disease at a later date or may develop it in the future, since the survey only included data from 2004 to 2014.

Stopping Brain Changes in Parkinson's Disease

Researchers are trying to find ways to remove protein tangles that have already formed in the brain of people with Parkinson's disease as well as to prevent the tangles from forming.

Hope for the Future

I suspect that it's going to take some time and effort to clarify all of the factors involved in Salbutamol's influence on the risk of Parkinson's disease. The effort could be very worthwhile, however. If scientists discover more details about the effects of salbutamol or identify a different reason for a reduced risk of Parkinson's disease, it's possible that in the future many people could be protected from the illness. It might even be possible to offer people better help if they already have the disease.

The results of the Harvard research are interesting and exciting. There are unanswered questions linked to the research, however, which is why nobody should change their current medication use without their doctor's recommendation. I hope that the answers to the questions are discovered as soon as possible.

References

  • "What Is Asthma?" National Heart, Lung, and Blood Institute. https://www.nhlbi.nih.gov/health/health-topics/topics/asthma/ (accessed September 3, 2017).
  • "Parkinson's disease." Mayo Clinic. http://www.mayoclinic.org/diseases-conditions/parkinsons-disease/basics/definition/con-20028488 (accessed September 3, 2017).
  • Leslie, Mitch. "Asthma drug may thwart Parkinson's disease." American Association for the Advancement of Science. http://www.sciencemag.org/news/2017/08/asthma-drug-may-thwart-parkinson-s-disease (accessed September 3, 2017).
  • Norton, Amy. "New hope from old drugs in fight against Parkinson's." Medical Xpress. https://medicalxpress.com/news/2017-08-drugs-beta2-adrenoreceptor-linked-parkinson-disease.html (accessed September 3, 2017).
  • Torrice, Michael. "Asthma drugs may reduce Parkinson's risk." American Chemical Society. http://cen.acs.org/articles/95/i35/Asthma-drugs-reduce-Parkinsons-risk.html (accessed September 5, 2017).

© 2017 Linda Crampton

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    • AliciaC profile image
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      Linda Crampton 10 days ago from British Columbia, Canada

      Hi, Dianna. I hope researchers discover more about the relationship between salbutamol and Parkinson's disease. It would be wonderful if it could be used as an effective medication to prevent or treat the disease. I hope Parkinson's is one day a thing of the past, as you do.

    • teaches12345 profile image

      Dianna Mendez 10 days ago

      This must be a real life saver for many with Parkinsons. I hope that these afflications are a thing of the past one day.

    • AliciaC profile image
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      Linda Crampton 10 days ago from British Columbia, Canada

      Hi, Nithya. I hope the research leads to some great benefits. Thanks for the visit.

    • Vellur profile image

      Nithya Venkat 11 days ago from Dubai

      I hope further research on Salbutamol helps to find a cure for Parkinson's disease. Learned a lot about Parkinson's and Salbutamol after reading your article. Thank you for sharing.

    • AliciaC profile image
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      Linda Crampton 12 days ago from British Columbia, Canada

      I'm sorry about your situation, Corrine. I wouldn't give up hope, though. I read a lot of medical news and it seems to me that the amount of research into neurodegenerative diseases and disorders involving misfolded proteins is increasing. Best wishes to you.

    • profile image

      Corinne Bauer 12 days ago

      I am 72 and 12 years into Parkinsons. Many times I have been excited or at least hopeful when people think they have the answer. It takes so long for the studies. I am sure none of the people doing the studies has Parkinson or they would not be so slow. I suspect that there will be a cure found, probably the day of my funeral.

    • AliciaC profile image
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      Linda Crampton 2 weeks ago from British Columbia, Canada

      Thanks, DDE. Yes, Parkinson's disease can be a challenge. My grandmother had the disorder.

    • profile image

      DDE 2 weeks ago

      Interesting and an important topic. I know of people with Parkinsons and it is a challenge indeed.

    • AliciaC profile image
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      Linda Crampton 2 weeks ago from British Columbia, Canada

      Thank you, Larry. I appreciate your visit.

    • Larry Rankin profile image

      Larry Rankin 2 weeks ago from Oklahoma

      Very informative!

    • AliciaC profile image
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      Linda Crampton 2 weeks ago from British Columbia, Canada

      Hi, Dora. Yes, I like to hear the word "cure" with respect to a disease, as long as the information is reliable. I hope researchers discover cures for many diseases in the near future. Thanks for the visit.

    • MsDora profile image

      Dora Isaac Weithers 2 weeks ago from The Caribbean

      "The condition can be treated but not cured." I always hope that the findings are wrong whenever I read this about any condition. It would be great if the Harvard researchers can stumble upon a cure for both asthma and Parkinson's. Thanks for presenting these interesting and informative data.

    • AliciaC profile image
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      Linda Crampton 2 weeks ago from British Columbia, Canada

      Hi, Bill. Thanks for the visit and the comment. I'm story to hear that Bev has asthma.

    • billybuc profile image

      Bill Holland 2 weeks ago from Olympia, WA

      We are quite familiar with inhalers here. Bev has had asthma for years....the link to Parkinson's is very interesting, Linda. Great research as always!

    • AliciaC profile image
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      Linda Crampton 2 weeks ago from British Columbia, Canada

      Thanks, Jackie. Scientists have certainly made lots of useful discoveries. I hope they continue to do so!

    • AliciaC profile image
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      Linda Crampton 2 weeks ago from British Columbia, Canada

      Thanks for the comment and for sharing the interesting information, Flourish. It does seem that we are missing the big picture in research sometimes. I hope the situation for people with Parkinson's disease improves soon.

    • Jackie Lynnley profile image

      Jackie Lynnley 2 weeks ago from The Beautiful South

      Very interesting and easy to follow. Very well done.

      I do hope they have answers soon because of course we can't use these inhalers to prevent Parkinson's Disease so I am sure they can come up with something, eventually. Science has come so far and done so many great things, haven't they?

    • FlourishAnyway profile image

      FlourishAnyway 2 weeks ago from USA

      Fascinating as all of your articles are. I wonder whether they were specifically looking at this as a hypothesis when analyzing the survey data or whether it was more of a fishing expedition approach and they found these results (which I know happens but is not good). Either way, it's very possible they are on to something. In so much scientific research I feel we are missing big picture thinking. For example, there is a relatively new finding that melanoma and Parkinson's are linked. I wish there was some organized effort to integrate this research with the information you present here as well as other key findings. I think of Michael J. Fox and others who struggle with the illness and sincerely hope a cure is in the future.