[The pathogenesis of chronic obstructive pulmonary disease, steroid resistance and the place of theophylline in the treatment].
Chronic obstructive pulmonary disease (COPD) is associated with airway obstruction, which is not fully reversible. It results from an abnormal inflammatory response of lungs to inhaled noxious agents and gases. There is a complex inflammation involving proximal and peripheral airways, lung parenchyma and pulmonary vascular structures in COPD. The inflammation is resistant to steroids, and it is believed that there may be a defect in the anti-inflammatory effects of these drugs in COPD. Recent studies reported an association between steroid resistance and decreased histone deacetylase (HDAC)-2 activity in lung cells of COPD patients. More recently, laboratory studies suggest that theophylline, at low doses, may reverse steroid resistance by enhancing decreased HDAC-2 activity. However, these findings need to be tested and confirmed in detailed clinical studies prior to implementation to clinical practice.
Bayram
Hasan
H
Department of Chest Diseases, Faculty of Medicine, Gaziantep University, Gaziantep, Turkey. bayram@gantep.edu.tr
D001993:Bronchodilator Agents / Q000494:pharmacology / Q000627:therapeutic use*; D004351:Drug Resistance; D006655:Histone Deacetylases / Q000378:metabolism*; D006801:Humans; D007249:Inflammation; D029424:Pulmonary Disease, Chronic Obstructive / Q000188:drug therapy* / Q000201:enzymology; D013256:Steroids / Q000494:pharmacology / Q000627:therapeutic use; D013806:Theophylline / Q000494:pharmacology / Q000627:therapeutic use*
D001993:Bronchodilator Agents; D013256:Steroids; D013806:Theophylline; D006655:Histone Deacetylases