Pharmacogenomic Pathways and Phenotypes

At the cellular level, eosinophils, mast cells, alveolar macrophages, lymphocytes and neutrophils recruited to the airways of asthmatics produce a variety of inflammatory mediators, such as histamine, kinins, neuropeptides, and leukotrienes, which lead to airway smooth muscle constriction and obstruction of airflow, and the perpetuation of airway inflammation [20, 21]. An understanding of the inflammatory processes and the molecular pathways of these mediators has led to the development and widespread use of several pharmacologic agents that mitigate airway inflammation and bronchoconstriction. 

There are four major classes of asthma pharmacotherapy currently in widespread use [22, 23]  

1) beta2-agonists (/1-agonists) used by inhalation for the relief of airway obstruction (e.g., albuterol, salmeterol, fenoterol)  

2) glucocorticosteroids for both inhaled and systemic use (e. g., beclomethasone, triamcinolone, prednisone)  

3) theophylline and its derivatives, used for both the relief of bronchospasm and the control of inflammation and 

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