The Clinical Pharmacology of Past, Present, and Future Glucocorticoids

Nocentini, Giuseppe; Ronchetti, Simona; Bruscoli, Stefano; Riccardi, Carlo

doi:10.1007/978-3-319-16056-6_5

Cited by 5 publications

(4 citation statements)

References 78 publications

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“…They show an inhibitory effect on the synthesis and release of proinflammatory cytokines, such as IL-1, IL-2, IL-3, IL-6, interferon-γ and TNF-α. Through lipocortin-dependent inhibition of membrane phospholipase A-2 (PLA-2) enzyme activity, GCSs block the release of arachidonic acid (AA), the main substrate for COX-1 and COX-2 cyclooxygenases, and thus prevent the synthesis of inducible inflammatory mediators such as prostaglandins (PGs) and LTs [57][58][59][60][61].…”

Section: Current and Future Pharmacological Methods Of Prevention Andmentioning

confidence: 99%

Pathophysiological mechanisms and pharmacological methods of prevention and treatment of bronchopulmonary dysplasia in preterm infants

Wątroba¹,

Bryda²

2019

J Pre Clin Clin Res.

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Wątroba S. J, Bryda J. Pathophysiological mechanisms and pharmacological methods of prevention and treatment of bronchopulmonary dysplasia in preterm infants. AbstractIntroduction. Bronchopulmonary dysplasia (BPD) is a respiratory disease that is characterized by long-term respiratory failure and mainly affects premature infants with low birth weight (LBW), undergoing mechanical ventilation (MV) or requiring long-term oxygen therapy. In Europe, among newborns with birth weight <1500g, the incidence of BPD is around 15%. Objective. The purpose of this review was to analyze the pathophysiological mechanisms involved in the development of BPD in premature newborns and to discuss the current possibilities of pharmacological prevention and treatment of BPD. Description of the state of knowledge. The BPD pathogenesis is multifactorial. Lung damage is the result of barotrauma and volutrauma due to high-performance MV, actions of reactive oxygen species (ROS) and infectious agents. Currently used methods of pharmacological treatment of severe forms of BPD are mainly based on systemic steroid therapy and can not be considered completely effective and free of side effects. Conclusion. Despite the widespread use of proper pharmacotherapy and dynamic development of new methods of respiratory therapy, mortality in BPD is estimated at around 10% -20%. Infants with BPD are much more exposed to respiratory infections caused by respiratory syncytial virus (RSV), which may result in the development of bronchial hyperresponsiveness and bronchial asthma. Among children with BPD there are significantly higher cognitive and behavioral deficits compared to healthy children, and cerebral palsy is also significantly more common.Abbreviations AA -arachidonic acid; AAP COFN -Committee on Foetus and Newborn of the American Academy of Pediatrics; ACTHadrenocorticotropin; ADH -vasopressin, antidiuretic hormone; ASMC -airway smooth muscle cells; BPD -bronchopulmonary dysplasia; BTN -betamethasone; CAT -catalase; CC10 -Clara cell 10 kDa protein; CLD -chronic lung disease; COXcyclooxygenase; CPAP -continuous positive airway pressure; CPS FNC -Fetus and Newborn Committee of the Canadian Pediatric Society; DEX -dexamethasone; ELBW -extremely low birth weight; ENA-78 -epithelial protein activating neutrophils; EURAIL -Europe Against Immature Lung; FC -fludrocortisone; FiO 2 -oxygen concentration in the breathing mixture; FTP -fluticasone propionate; GCSs -glucocorticosteroids; GM-CSF -granulocyte and macrophage colonystimulating factor; GPx -glutathione peroxidase; HC -hydrocortisone; HO . -hydroxyl radical; HO 2 . -hydroperoxide radical; IFN-γ -gamma interferon; ILs -interleukins; IRDS -respiratory distress syndrome; IUGR -intrauterine growth retardation; IVH -intraventricular haemorrhage; LBW -low birth weight; LTs -leukotrienes; MAS -meconium aspiration syndrome; MIP-1 -macrophage inflammatory protein-1; MMPs -metalloproteinases; MRI -magnetic resonance imaging; MV -mechanical ventilation; n-CPAP -continuous positive airway pressure -nasal metho...

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Section: Current and Future Pharmacological Methods Of Prevention Andmentioning

confidence: 99%

Pathophysiological mechanisms and pharmacological methods of prevention and treatment of bronchopulmonary dysplasia in preterm infants

Wątroba¹,

Bryda²

2019

J Pre Clin Clin Res.

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“…The serum t1/2 for prednisone is 2 hours, and tissue t1/2 is 12–36 hours; serum t1/2 of methylprednisolone is 2.3 hours, and tissue t1/2 is 12–36 hours; and serum t1/2 of dexamethasone is 3.5 hours, and tissue t1/2 is 36–54 hours. 44 To date, no randomized controlled trial has examined the duration of steroid therapy. Further research is therefore needed to determine how often steroids should be administered in this patient population.…”

Section: Duration Of Steroid Therapymentioning

confidence: 99%

Research progress in refractory sudden hearing loss: steroid therapy

Liu

Chen

2020

J Int Med Res

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Sudden sensorineural hearing loss (SSNHL) is a common condition with a rapid onset, and its worldwide frequency is increasing each year. Importantly, a significant number of patients with SSNHL do not respond to initial treatment, which is termed refractory sudden hearing loss (RSHL), and further treatment is not standardized in terms of type, duration, administration route, and concentration of topical steroid therapy. Dexamethasone and methylprednisolone are effective in treating RSHL, and salvage treatment typically consists of 2 weeks of steroid therapy followed by 3-6 months of follow-up. Near-continual steroid perfusion appears to be more effective than intermittent steroid injection. Furthermore, several novel therapeutic regimens have shown promising results in small-scale studies. However, the optimum treatment needs to be confirmed in larger randomized controlled trials.

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“…When administered by inhalation, SMDs have specific pharmacokinetic properties that prevent systemic adverse effects (). Most new‐generation topical inhaled glucocorticoids are in fact characterized by low systemic bioavailability, high clearance, local activation, and/or strong tendency to form lipid conjugates, resulting in high drug concentrations in lower airway epithelial cells and slow drug redistribution . These features are shared by the highly lipophilic long‐acting beta‐agonists (LABA) and muscarinic antagonists .…”

Section: Main Pharmacological Features Of Biologicals and Smds For Asmentioning

confidence: 99%

Comparing biologicals and small molecule drug therapies for chronic respiratory diseases: An EAACI Taskforce on Immunopharmacology position paper

Roth‐Walter

Adcock

Benito-Villalvilla

et al. 2019

Allergy

Self Cite

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Signal transducer and activator of transcription protein; Th17, T helper cells that produce interleukin-17; Th1, T helper 1; Th2, T helper 2; Th9, T helper cells that produce interleukin-9; TNFα, Tumor necrosis factor alpha; TSLP, Thymic stromal lymphopoietin; TBXA2, Tromboxane receptor A2; ULABA, Ultra-long-acting beta-agonists; ULAMA, ultra-long-acting muscarinic agonists; WHO, World Health Organization. † The Task Force of Immunopharmacology (TIPCO) within the Immunology Section of EAACI was established in 2017 to connect scientist and clinicians with the different scientific backgrounds-physicians and basic scientists, pharmacologists, computational biologists-with the task of examining recent breakthroughs on basic mechanisms of immune regulation and review their application in current, upcoming, and paradigm-shifting therapeutic approaches for allergy and clinical immunology-related diseases. The different topics for this first position paper, based on comparison of biologicals and small molecule drug therapeutic approaches, were assigned and drafted by authors' subgroups. They were further discussed, developed, and compiled during a meeting in Salerno (February 24-25, 2018). The position paper draft was thereafter recirculated and critically appraised until the final version was approved by all Task Force Members. AbstractChronic airway diseases such as asthma and chronic obstructive pulmonary disease (COPD), together with their comorbidities, bear a significant burden on public health. Increased appreciation of molecular networks underlying inflammatory airway disease needs to be translated into new therapies for distinct phenotypes not controlled by current treatment regimens. On the other hand, development of new

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The Clinical Pharmacology of Past, Present, and Future Glucocorticoids

Cited by 5 publications

References 78 publications

Pathophysiological mechanisms and pharmacological methods of prevention and treatment of bronchopulmonary dysplasia in preterm infants

Pathophysiological mechanisms and pharmacological methods of prevention and treatment of bronchopulmonary dysplasia in preterm infants

Research progress in refractory sudden hearing loss: steroid therapy

Comparing biologicals and small molecule drug therapies for chronic respiratory diseases: An EAACI Taskforce on Immunopharmacology position paper

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