The effect of tiotropium therapy on markers of elastin degradation in COPD

Respir Res. 2009 Feb 25;10(1):12. doi: 10.1186/1465-9921-10-12.


Background: Desmosine and Isodesmosine (D/I) are cross-linking amino acids which are present only in mature elastin. Changes in their concentration in body fluids indicate changes in elastin degradation and can be a reflection of tissue elastase activity. This study was undertaken to determine whether continuous therapy with the long-acting bronchodilator Tiotropium bromide (TTP) could result in reductions in D/I as measured by mass spectrometry in plasma, urine and sputum.

Methods: Twelve not currently smoking patients with chronic obstructive pulmonary disease (COPD), never on TTP, were selected for study. Levels of D/I, along with measurements of FVC, FEV1 and FEV1/FVC. were determined before starting TTP daily, and then one and two months after.

Results: D/I decreased in plasma (10 of 12 patients), in sputum all (12 of 12), and in the percentage of free D/I in urine (10 of 12). Most patients showed slight increases in FVC and FEV1 percent predicted over two months.

Conclusion: The results are consistent with an effect of prolonged bronchodilitation by anti-cholinergic blockade to also result in reduced lung elastin degradation.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Bronchodilator Agents / therapeutic use*
  • Desmosine / blood
  • Desmosine / metabolism
  • Desmosine / urine
  • Elastin / metabolism*
  • Forced Expiratory Volume
  • Humans
  • Isodesmosine / blood
  • Isodesmosine / metabolism
  • Isodesmosine / urine
  • Pancreatic Elastase / drug effects
  • Pancreatic Elastase / metabolism
  • Pulmonary Disease, Chronic Obstructive / drug therapy*
  • Pulmonary Disease, Chronic Obstructive / physiopathology
  • Scopolamine Derivatives / therapeutic use*
  • Smoking Cessation
  • Tiotropium Bromide
  • Vital Capacity


  • Bronchodilator Agents
  • Scopolamine Derivatives
  • Desmosine
  • Elastin
  • Isodesmosine
  • Pancreatic Elastase
  • Tiotropium Bromide