Glucocorticoids asthma

Asthma attacks less than twice a week FEV1 >80% Rapid-acting inhaled p2-agonist Low dose inhaled glucocorticoid or cromone (children)... 

Asthma attacks more than twice a week FEV1 60-80% daily use of bronchodilators. Rapid-acting inhaled p2-agonist Inhaled glucocorticoid... 

Severe, life-threatening asthma attacks inhaled p2-agonists ineffective Oxygen Glucocorticoids oral or i.v. 

Asthma is a chronic inflammatory disease. Therefore steroids represent the most important and most frequently used medication. Already after the fust treatment, steroids reduce cellular infiltration, inflammation, and the LAR, whereas changes in the EAR require prolonged treatment to lower the existent IgE levels. The mechanisms of steroid actions are complex and only incompletely understood. Besides their general antiinflammatory properties (see chapter glucocorticoids), the reduction of IL-4 and IL-5 production from T-lymphocytes is particularly important for asthma therapy. The introduction of inhaled steroids, which have dramatically limited side effects of steroids, is considered one of the most important advancements in asthma therapy. Inhaled steroids (beclomethasone, budesonide, fluticasone, triamcinolone, momethasone) are used in mild, moderate, and partially also in severe asthma oral steroids are used only in severe asthma and the treatment of status asthmaticus. Minor side effects of most inhaled steroids are hoarseness and candidasis, which are avoided by the prodrug steroid ciclesonide. 

Corticosteroids Glucocorticoid agonists Steroids Asthma controllers... 

Glucocorticoids are widely used to treat a variety of inflammatory and immune diseases. With the recognition that airway inflammation is present even in patients with mild asthma, treatment with glucocorticoids is now the mainstay of asthma therapy. Consequently, by far the most common use of glucocorticoids today is in the treatment of asthma and inhaled glucocorticoids have now become established as first-line treatment in adults and children with persistent asthma, the commonest chronic airway inflammatory disease. 

Glucocorticoids Immunosuppressive Agents Bronchial Asthma Allergy... 

Xystrakis E, Kusumakar S, Boswell S, et al Reversing the defective induction of IL-lO-secreting regulatory T cells in glucocorticoid-resistant asthma patients. J Clin Invest 2006 116 146-155. 

Loke TK, Sousa AR, Corrigan CJ, Lee TH. (2002) Glucocorticoid-resistant asthma. Curr Allergy Asthma Rep. 2, 144-150. 

Sousa AR, Lane SJ, Cidlowski JA, Staynov DZ, Lee TH. (2000) Glucocorticoid resistance in asthma is associated with elevated in vivo expression of the glucocorticoid receptor beta-isoform. J Allergy Clin Immunol. 105, 943-950. 

Christodoulopoulos P, Leung DY, Elliott MW, et al. (2000) Increased number of glucocorticoid receptor-beta-expressing cells in the airways in fatal asthma. J Allergy Clin Immunol. 106, 479-484. 

Hamid QA, Wenzel SE, Hank PJ, et al. (1999) Increased glucocorticoid receptor beta in airway cells of glucocorticoid-insensitive asthma. Am J Respir Crit Care Med. 159(5 pt. 1), 1600-1604. 

Bergeron C, Fukakusa M, OUvenstein R, et al. (2006) Increased glucocorticoid receptor-beta expression, but not decreased histone deacetylase 2, in severe asthma. J Allergy Clin Immunol. 117,703-705. 

Glucocorticoids are potent anti-inflammatory agents that find multiple clinical uses, including treatment of arthritis and asthma. 

Dexamethasone Synthetic glucocorticoid, lacks mineralocorticoid activity Used to treat range of inflammatory diseases. Used to treat some forms of asthma, also cerebral oedema and congenital adrenal hyperplasia... 

---