Pharmacological treatment of asthma today: Table 1

Abstract

The current concept of asthma therapy is based on a stepwise approach, depending on disease severity, and the aim is to reduce the symptoms that result from airway obstruction and inflammation, to prevent exacerbations and to maintain normal lung function.b 2 -Adrenoceptor agonists and glucocorticoids are at present the most effective drugs for the treatment of airway obstruction and inflammation, with theophylline, leukotriene receptor antagonists and anticholinergics as second-or third-line therapy. There are, to date, no additional or newly developed drugs available that add substantially to the current strategies or even replace b 2 -adrenoceptor agonists or glucocorticoids. New approaches in asthma therapy recommend drug combinations of inhaled steroids, primarily with long-acting b 2 -adrenoceptor agonists, based on their improved efficacy and the potential for a steroid-sparing effect.Although existing drug entities are able to control the vast majority of patients with mild and moderate asthma, patients9 (and doctors9) adherence to guidelines and treatment strategies falls well short of the desired standards.Treatment choices, however, differ between countries and should take into account convenience to the patient and the occurrence of side-effects. Additionally, the cost of therapy and reimbursement policies also influences therapeutic strategies.

The early allergic response in small airways of human precision-cut lung slices

“…They found that the H1-receptor antagonist triprolidine was ineffective, and CysLT-or TP-receptor blockade was effective only in some cases. These findings are in line with no proven and documented benefit of antihistamines in asthma [48], and with the clinical observations of CysLT1-and TP-receptor antagonists being effective only in subsets of patients [46][47][48][49][50][51]. Notably, however, simultaneous blockade of CysLT-and TPreceptors provided nearly complete protection from antigeninduced airway contraction in PCLS from all individuals.…”

Characterisation of guinea pig precision-cut lung slices: comparison with human tissues

“…The relative contributions of the individual mediators may well differ along the airway tree and be related to differences in amounts of released mediators, airway geometry and expression of receptors. Again, when all three classes are blocked, there is complete protection [7,9,30,32,35].…”

Identification of higenamine in Radix AconitiLateralis Preparataas a beta2-adrenergic receptor agonist1

“…Therefore, higenamine was markedly effective in reducing the severity of bronchoconstriction following the exposure of guinea pigs to atomized histamine solutions. β 2 -AR agonists, as bronchodilators, have been used for the relief and prophylaxis of asthma for more than 30 years [1] . On the other hand, there are hundreds of different kinds of herbs used for the treatment of asthma in TCM.…”

“…Beta2-adrenergic receptor (β 2 -AR) agonists have been used for the relief and prophylaxis of asthma symptoms for many years [1] . The β 2 -ARs are mainly located in the alveolar walls [2] and mediate the relaxation of human airway smooth muscle in vivo and in vitro [3] .…”