title: Preventing asthma exacerbations: what are the targets?
abstract: Exacerbations of asthma are the main cause of asthma morbidity. They induce acute respiratory failure, and sometimes death. Two immunological signals acting in synergy are necessary for inducing asthma exacerbations. The first, triggered by allergens and/or unknown agents leads to the chronic Th2 inflammation characteristic of asthma. The second, caused by either viral infection, allergens, pollutants or a combination of these, results in an acute Th1 and Th2 inflammation precipitating symptoms. In both, innate and adaptive immunities are involved, providing a series of potential targets for therapy. Molecules associated to the first, chronic inflammation constitute targets for preventing therapies, when these related to the second, acute signal provide the rationale for curative treatments. Toll like receptors and bronchial epithelial cell-derived cytokines, engaged upstream of inflammation constitute interesting candidates for future treatments. The great heterogeneity of asthma has to be taken into account when considering targets for therapy to identify clusters of responders and nonresponders, and an integrative system biology approach will be necessary to go further.
authors: INSERM, U915, Nantes, F-44000, France.
authors: Karine
authors: K
authors: Botturi
authors: Marie
authors: M
authors: Langelot
authors: David
authors: D
authors: Lair
authors: Anaïs
authors: A
authors: Pipet
authors: Mallory
authors: M
authors: Pain
authors: Julie
authors: J
authors: Chesne
authors: Dorian
authors: D
authors: Hassoun
authors: Yannick
authors: Y
authors: Lacoeuille
authors: Arnaud
authors: A
authors: Cavaillès
authors: Antoine
authors: A
authors: Magnan
mesh_terms: D000485:Allergens / Q000276:immunology; D000818:Animals; D001249:Asthma / Q000188:drug therapy* / Q000276:immunology*; D016207:Cytokines / Q000276:immunology; D018450:Disease Progression; D006801:Humans; D007249:Inflammation / Q000276:immunology; D058990:Molecular Targeted Therapy / Q000379:methods*
chemical_list: D000485:Allergens; D016207:Cytokines