PMID- 14531240
OWN - NLM
STAT- MEDLINE
DCOM- 20040213
LR  - 20190101
IS  - 1079-2082 (Print)
IS  - 1079-2082 (Linking)
VI  - 60
IP  - 19
DP  - 2003 Oct 1
TI  - Current and emerging therapies for the management of chronic inflammation in 
      asthma.
PG  - 1949-59; quiz 1960-1
AB  - The pathophysiology of asthma, current treatment guidelines, and emerging 
      immunomodulating treatments are reviewed. Asthma is a chronic disease of 
      inflammation, which left untreated, may result in irreversible lung damage. 
      Inhaled antigens elicit a T-helper cell type-2 response, leading to the 
      production of immunoglobulin E (IgE) and eosinophil sensitization. Eosinophil 
      infiltration into the airway is thought to play an important role in chronic 
      inflammation and increases several weeks before an acute exacerbation in moderate 
      to severe asthma. The updated guidelines from the National Asthma Education and 
      Prevention Program and the National Institutes of Health focus on the use of 
      daily antiinflammatory treatment in patients with persistent asthma. Inhaled 
      corticosteroid (ICS) therapy remains the cornerstone for controlling mild and 
      moderate asthma, but when used in higher doses for moderate-to-severe asthma it 
      may cause long-term adverse effects, including osteoporosis and glaucoma. Step-up 
      therapy should be the combination of a long-acting beta-agonist (LABA) and an 
      ICS. Leukotriene modifiers may provide additional symptom control in patients 
      with moderate to severe asthma but have not been shown to be as cost-effective as 
      monotherapy. Newer entities focus on direct immune modulation and include 
      monoclonal antibodies targeting various inflammatory-response receptors (IgE, 
      interleukin [IL]-2, IL-4, and IL-5). Phosphodiesterase-4 (PDE-4) inhibitors may 
      be effective for chronic obstructive pulmonary disease, but have not delivered 
      consistent results for controlling asthma. Cytokine-receptor antagonists and 
      leukocyte-suppressing antiinflammatory drugs (LSAIDs) are currently under 
      investigation and have yielded promising preliminary results as alternatives for 
      the treatment of asthma. Current and emerging therapies for the management of 
      chronic inflammation in asthma include ICSs, LABAs, leukotriene modifiers, 
      monoclonal antibodies, PDE-4 inhibitors, cytokine-receptor antagonists, and 
      LSAIDs.
FAU - DeKorte, Carrie J
AU  - DeKorte CJ
AD  - Midwestern University-Glendale, 19555 North 59th Avenue, Glendale, AZ 85308, USA.
LA  - eng
PT  - Journal Article
PT  - Review
PL  - England
TA  - Am J Health Syst Pharm
JT  - American journal of health-system pharmacy : AJHP : official journal of the 
      American Society of Health-System Pharmacists
JID - 9503023
RN  - 0 (Adrenal Cortex Hormones)
RN  - 0 (Anti-Allergic Agents)
RN  - 0 (Anti-Asthmatic Agents)
RN  - 0 (Antibodies, Monoclonal)
RN  - 0 (Leukotriene Antagonists)
SB  - IM
MH  - Adrenal Cortex Hormones/therapeutic use
MH  - Anti-Allergic Agents/therapeutic use
MH  - Anti-Asthmatic Agents/therapeutic use
MH  - Antibodies, Monoclonal/therapeutic use
MH  - Asthma/*drug therapy
MH  - Chronic Disease
MH  - Drug Therapy, Combination
MH  - Humans
MH  - Leukotriene Antagonists/therapeutic use
MH  - Metered Dose Inhalers
MH  - Practice Guidelines as Topic
RF  - 89
EDAT- 2003/10/09 05:00
MHDA- 2004/02/14 05:00
CRDT- 2003/10/09 05:00
PHST- 2003/10/09 05:00 [pubmed]
PHST- 2004/02/14 05:00 [medline]
PHST- 2003/10/09 05:00 [entrez]
PST - ppublish
SO  - Am J Health Syst Pharm. 2003 Oct 1;60(19):1949-59; quiz 1960-1.