Are there any realistic chances to develop new drugs for asthma?
Asthma bronchiale, an inflammatory airway disease, imposes a significant health care problem worldwide. It is characterized by three critical phenotypic traits: intermittent and reversible bronchoconstriction, bronchial hyperresponsiveness and airway inflammation. Conventional therapy basically consists of beta(2)-adrenoceptor agonists in combination with glucocorticoids. Nevertheless, there is an urgent need for novel therapies, both for patients with uncontrollable disease symptoms and for those suffering from glucocorticoid-insensitive asthma. Monotherapy seems to be relatively ineffective against this complex and multifaceted disease, which is evident by the variety of disappointing treatment strategies. Thus, we should instead concentrate on multiple target strategies, such as novel and more potent glucocorticoids or phosphodiesterase type 4 (PDE4) inhibitors with isozyme selectivity. In addition, an examination of the application method should not be neglected, with emphasis on inhalative approaches. To summarize, research into asthma's pathophysiology is of critical importance, concentrating on human-relevant targets and conducting preliminary studies. With these imperatives in mind, we can hope to better manage this multifactor disease in the near future.
Amon
Annette
A
Department of Experimental and Clinical Pharmacology and Toxicology, University of Erlangen, Erlangen, Germany.
Pahl
Andreas
A
Szelenyi
Istvan
I
D000280:Administration, Inhalation; D000284:Administration, Oral; D000818:Animals; D018927:Anti-Asthmatic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001249:Asthma / Q000188:drug therapy*; D001993:Bronchodilator Agents / Q000627:therapeutic use; D018925:Chemokines / Q000037:antagonists & inhibitors / Q000502:physiology; D000529:Complementary Therapies; D015316:Genetic Therapy; D006801:Humans; D007114:Immunization; D018836:Inflammation Mediators; D061965:Matrix Metalloproteinase Inhibitors; D020928:Mitogen-Activated Protein Kinases / Q000037:antagonists & inhibitors; D016328:NF-kappa B / Q000502:physiology; D000067856:Poly(ADP-ribose) Polymerase Inhibitors; D011065:Poly(ADP-ribose) Polymerases / Q000502:physiology; D011505:Protein-Tyrosine Kinases / Q000037:antagonists & inhibitors
D018927:Anti-Asthmatic Agents; D001993:Bronchodilator Agents; D018925:Chemokines; D018836:Inflammation Mediators; D061965:Matrix Metalloproteinase Inhibitors; D016328:NF-kappa B; D000067856:Poly(ADP-ribose) Polymerase Inhibitors; D011065:Poly(ADP-ribose) Polymerases; D011505:Protein-Tyrosine Kinases; D020928:Mitogen-Activated Protein Kinases