Asthma therapeutic approaches

The accumulation of evidence implicating a role for adenosine in the pathogenesis of airway inflammation has led to investigations into all adenosine receptor subtypes as potential therapeutic targets for the treatment of asthma and COPD. To this end, the efficacy of A3AR in the clinical setting has been inconclusive. However, inhibition of Aj and A2B receptors and/or activation of the A2A pathway may serve as an alternative therapeutic approach (Brown et al. 2008b). 

Yuta A, BaraniukJN. Therapeutic approaches to mucus hypersecretion. Curr Allergy Asthma Rep. 2005 5 243-251. 

Brightling C, Berry M, Amrani Y. Targeting TNF-alpha a novel therapeutic approach for asthma. J. Allergy Clin. Immunol. 2008 121 5-10. 

With the role of S. aureus as disease modifier being established, a number of therapeutic approaches may be considered (fig. 2). The potential therapeutic effect of a treatment to eradicate S. aureus in polyp disease or asthma has not been studied yet, but large-scale double-blind placebo-controlled randomized studies are currently ongoing. From atopic dermatitis, a disease sharing the modifying effects of staphylococcal superantigens on inflammation and disease severity, we can deduce therapeutic approaches. The skin of up to 100% of patients with atopic dermatitis is colonized with S. aureus, of which up to 65% have been shown to produce enterotoxins with superantigenic properties. Ten patients were treated orally with antibiotics, chlorhexidine ointment was... 

Reseai ch aimed at the identification of novel antiarrythmic agents is targeting Cl channels. Cl channels are involved in cardiac arrythmia, asthma, CF and diarrhea, thus representing targets for therapeutic approaches. 

General Therapeutic Approaches to The Treatment and Management of Asthma... 

There are several papers that suggest that regular exercise has a tendency to prevent URTls (Nieman et al. 1998 Ernst et al. 2006). It does not seem to have been recommended as a preventative or therapeutic approach to asthma, or as a symptom-directed treatment for cough. This is not perhaps surprising since exercise may cause postexercise hyperreactivity, which usually includes coughing. 

The discovery of Intal(l, disodium cromoglycate, DSCC) a decade ago provided a new therapeutic approach to the treatment of asthma (1,2). Pharmacologically, Intal differs from previously used drugs in that it is not a bronchodilator, antihistamine, or antiinflammatory agent. Intal acts by inhibiting the release of the mediators of anaphylaxis and thus offers an alternative to the conventional approach which seeks to alleviate the symptoms of an allergic attack with bronchodilators (2). 

Asthma is certainly one of the diseases, if not the disease, that has benefited most from this therapeutic approach. 

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