Experimental treatments for asthma.
There has been increased recognition of the importance of inflammatory cells and their products in the pathogenesis of asthma. From this recognition has evolved a number of new approaches to treat the various components of the asthmatic inflammatory response. Nonselective anti-inflammatory agents such as cyclosporine and gold appear to decrease symptoms and allow a steroid-sparing effect in many cases, though side effects from cyclosporine often necessitate dose reduction. Novel oral compounds as the 5-lipoxygenase inhibitors have been effective in controlling asthma symptoms triggered by various stimuli, and the cysteinyl leukotriene receptor antagonists have shown promise in this regard as well. Neurokinin antagonists, inhaled loop diuretics, and lidocaine may play significant roles in asthma therapy through inhibition of neurogenic inflammation and possibly mast cell function. Inhibition of mast cell products by existing drugs such as heparin or the development of specific inhibitors of mast cell tryptase may also be effective agents, as are selective phosphodiesterase inhibitors, which appear to have anti-inflammatory properties. Finally, specific cytokine antagonists, agonists, inhibitors of T-cell function, selective inducible nitric oxide synthase inhibitors, and even gene-directed strategies may provide not only insights into the pathogenesis of asthma but also novel therapeutic approaches to treat the inflammation in this disease.
Floreani
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Pulmonary and Critical Care Medicine Section, University of Nebraska Medical Center, Omaha 68198-5300, USA.
Rennard
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SI
D000280:Administration, Inhalation; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D018501:Antirheumatic Agents / Q000627:therapeutic use; D001249:Asthma / Q000188:drug therapy*; D001310:Auranofin / Q000627:therapeutic use; D001920:Bradykinin / Q000037:antagonists & inhibitors; D018680:Cholinergic Antagonists / Q000627:therapeutic use; D053818:Chymases; D016572:Cyclosporine / Q000627:therapeutic use; D004232:Diuretics / Q000008:administration & dosage / Q000627:therapeutic use; D015507:Drugs, Investigational / Q000627:therapeutic use*; D015316:Genetic Therapy; D006494:Heparin Antagonists / Q000627:therapeutic use; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007705:Kinins / Q000037:antagonists & inhibitors; D020024:Leukotriene Antagonists; D008012:Lidocaine / Q000627:therapeutic use; D018727:Muscarinic Antagonists / Q000627:therapeutic use; D015288:Neurokinin A / Q000037:antagonists & inhibitors; D010726:Phosphodiesterase Inhibitors / Q000627:therapeutic use; D011451:Prostaglandin-Endoperoxide Synthases / Q000627:therapeutic use; D018039:Receptors, Tachykinin / Q000037:antagonists & inhibitors; D012697:Serine Endopeptidases / Q000378:metabolism; D013601:T-Lymphocytes / Q000276:immunology; D053802:Tryptases
D000893:Anti-Inflammatory Agents; D018501:Antirheumatic Agents; D018680:Cholinergic Antagonists; D004232:Diuretics; D015507:Drugs, Investigational; D006494:Heparin Antagonists; D007166:Immunosuppressive Agents; D007705:Kinins; D020024:Leukotriene Antagonists; D018727:Muscarinic Antagonists; D010726:Phosphodiesterase Inhibitors; D018039:Receptors, Tachykinin; D001310:Auranofin; D016572:Cyclosporine; D015288:Neurokinin A; D008012:Lidocaine; D011451:Prostaglandin-Endoperoxide Synthases; D012697:Serine Endopeptidases; C083294:chymase 2; D053818:Chymases; D053802:Tryptases; D001920:Bradykinin