1. How do we critically use long-acting muscarinic receptor antagonists and beta- adrenergic receptor agonists monotherapy, or these combination therapies depending on the situation in Japanese patients with COPD? 
Tomotaka Kawayama, Jun Sasaki 
Respiratory Investigation 
Volume 55, Issue 6, Pages (November 2017)
DOI: /j.resinv
Copyright © 2017 The Japanese Respiratory Society Terms and Conditions

2. Fig. 1
Pharmacologic treatment algorithms by GOLD grade [1]. Group C has a small population of patients. * Rofumilast, macrolide, and ICS monotherapy are not accepted in patients with COPD in Japan. ICS = inhaled corticosteroids, LABA = beta adrenergic receptor agonists, LAMA = long-acting muscarinic receptor antagonists.
Respiratory Investigation  , DOI: ( /j.resinv )
Copyright © 2017 The Japanese Respiratory Society Terms and Conditions

3. Fig. 2
Functional crosstalk between β2-adrenoreceptor and muscarinic acetylcholine receptor [3]. Gα proteins (α-subunit of G protein) are classified into four major subtypes: Gq-, Gs-, Gi- and G12/13. AC = adenylate cyclase, ATP = Adenosine triphosphate, β2AR = β2-adrenoreceptor, cAMP = cyclic adenosine monophosphate, DAG = 1,2-diacylglycerol, GPCRs = guanine nucleotide-binding protein (G protein) coupled receptors, GTP = guanosine triphosphate, IP3 = 1,4,5-triphosphate, M2 and M3 mAchR = muscarinic acetylcholine receptor 2 and 3, MLC = myosin light chain, MLCK = myosin light chain kinase, MLCP = myosin light chain phosphatase, PI-4 = Phosphatidylinositol 4-phosphate, PKA = protein kinase A, PKC = protein kinase C, PLCβ = phospholipase C-β.
Respiratory Investigation  , DOI: ( /j.resinv )
Copyright © 2017 The Japanese Respiratory Society Terms and Conditions