Inhaled Corticosteroids
Open Access
- 8 March 2010
- journal article
- review article
- Published by MDPI AG in Pharmaceuticals
- Vol. 3 (3), 514-540
- https://doi.org/10.3390/ph3030514
Abstract
Inhaled corticosteroids (ICS) are the most effective controllers of asthma. They suppress inflammation mainly by switching off multiple activated inflammatory genes through reversing histone acetylation via the recruitment of histone deacetylase 2 (HDAC2). Through suppression of airway inflammation ICS reduce airway hyperresponsiveness and control asthma symptoms. ICS are now first-line therapy for all patients with persistent asthma, controlling asthma symptoms and preventing exacerbations. Inhaled long-acting β2-agonists added to ICS further improve asthma control and are commonly given as combination inhalers, which improve compliance and control asthma at lower doses of corticosteroids. By contrast, ICS provide much less clinical benefit in COPD and the inflammation is resistant to the action of corticosteroids. This appears to be due to a reduction in HDAC2 activity and expression as a result of oxidative stress. ICS are added to bronchodilators in patients with severe COPD to reduce exacerbations. ICS, which are absorbed from the lungs into the systemic circulation, have negligible systemic side effects at the doses most patients require, although the high doses used in COPD has some systemic side effects and increases the risk of developing pneumonia.Keywords
This publication has 123 references indexed in Scilit:
- Combined corticosteroid and long-acting beta2 -agonist in one inhaler versus long-acting beta2 -agonists for chronic obstructive pulmonary diseaseEmergencias, 2012
- Role of Dual Specificity Phosphatases in Biological Responses to GlucocorticoidsOnline Journal of Public Health Informatics, 2008
- Global strategy for asthma management and prevention: GINA executive summaryEuropean Respiratory Journal, 2008
- Relative Corticosteroid Insensitivity of Peripheral Blood Mononuclear Cells in Severe AsthmaAmerican Journal of Respiratory and Critical Care Medicine, 2006
- Low-dose inhaled and nasal corticosteroid use and the risk of cataractsEuropean Respiratory Journal, 2006
- How corticosteroids control inflammation: Quintiles Prize Lecture 2005British Journal of Pharmacology, 2006
- Budesonide Inhalation Suspension for the Treatment of Asthma in Infants and ChildrenDrugs, 2005
- CiclesonideDrugs, 2004
- Mometasone furoate: efficacy and safety in moderate asthma compared with beclomethasone dipropionateAnnals of Allergy, Asthma & Immunology, 2001
- Budesonide delivered by Turbuhaler is effective in a dose-dependent fashion when used in the treatment of adult patients with chronic asthmaJournal of Allergy and Clinical Immunology, 1998