[Cortisone-resistant bronchial asthma].
There is general agreement on the inflammatory pathogenesis of bronchial asthma: an accumulation of activated eosinophils, degranulated mast cells, T lymphocytes and in very severe forms, granulocytes has constantly been found in the bronchial mucosa. In allergic bronchial asthma, inflammation seems to be orchestrated predominantly by a subset of T lymphocytes, with a phenotype similar to the Th2 subset able to produce IL-4 and IL-5. Although corticosteroids are the most potent therapeutic agents used for this disease, their anti-inflammatory effect differs from patient to patient. Some criteria which can be used to define steroid-resistant bronchial asthma are listed here. This review analyzes various molecular alterations responsible for the deficient response to corticosteroid treatment observed in steroid-resistant bronchial asthmatic subjects. New knowledge on the mechanism of steroid resistance may have important implications for the treatment of chronic asthma and other diseases.
Matucci
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U.O. di Immunoallergologia Clinica, Azienda Ospedaliera Careggi di Firenze.
Rossi
O
O
Ricci
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M
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D001249:Asthma / Q000188:drug therapy* / Q000276:immunology / Q000503:physiopathology; D003348:Cortisone / Q000627:therapeutic use; D016207:Cytokines / Q000096:biosynthesis; D004247:DNA / Q000378:metabolism; D004351:Drug Resistance; D006801:Humans; D066298:In Vitro Techniques; D015847:Interleukin-4 / Q000096:biosynthesis; D015848:Interleukin-5 / Q000096:biosynthesis; D010641:Phenotype; D011987:Receptors, Steroid / Q000032:analysis / Q000378:metabolism; D013601:T-Lymphocytes / Q000187:drug effects / Q000276:immunology*
D000305:Adrenal Cortex Hormones; D000893:Anti-Inflammatory Agents; D016207:Cytokines; D015848:Interleukin-5; D011987:Receptors, Steroid; D015847:Interleukin-4; D004247:DNA; D003348:Cortisone