How Do Corticosteroids Work in Asthma?

Reviews2 September 2003How Do Corticosteroids Work in Asthma?Peter J. Barnes, DM, DSc and Ian M. Adcock, PhDPeter J. Barnes, DM, DScFrom National Heart and Lung Institute, Imperial College, London, United Kingdom.Search for more papers by this author and Ian M. Adcock, PhDFrom National Heart and Lung Institute, Imperial College, London, United Kingdom.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-139-5_Part_1-200309020-00012 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Clinical PrinciplesAsthma is the most common chronic disease in westernized countries.Patients with asthma have an underlying chronic inflammation of the airways characterized by activated mast cells, eosinophils, and T-helper 2 lymphocytes. This results in increased responsiveness of the airways to such triggers as exercise, allergens, and air pollutants.This chronic inflammation underlies the typical symptoms of asthma, which include intermittent wheezing, coughing, shortness of breath, and chest tightness.Corticosteroids are the most effective treatment for asthma, and inhaled corticosteroids have become first-line treatment for children and adults with persistent symptoms.Corticosteroids suppress the chronic airway inflammation in patients with asthma, and the molecular ...References1. Busse WW, Lemanske RF. Asthma. N Engl J Med. 2001;344:350-62. [PMID: 11172168] CrossrefMedlineGoogle Scholar2. Barnes PJ, Chung KF, Page CP. Inflammatory mediators of asthma: an update. Pharmacol Rev. 1998;50:515-96. [PMID: 9860804] MedlineGoogle Scholar3. Barnes PJ, Adcock IM. Transcription factors and asthma. Eur Respir J. 1998;12:221-34. [PMID: 9701442] CrossrefMedlineGoogle Scholar4. 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Google Scholar Author, Article, and Disclosure InformationAffiliations: From National Heart and Lung Institute, Imperial College, London, United Kingdom.Disclosures:Grants received: P.J. Barnes, I.M. Adcock (GlaxoSmithKline and AstraZeneca); Grants pending: P.J. Barnes, I.M. Adcock (GlaxoSmithKline and AstraZeneca).Corresponding Author: P.J. Barnes, DM, DSc, Department of Thoracic Medicine, National Heart and Lung Institute, Dovehouse Street, London SW3 6LY, United Kingdom; e-mail, p.j.[email protected]ac.uk. 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Calculi for Systems Biology and applications in severe asthmaRole of exhaled nitric oxide in predicting steroid response in chronic obstructive pulmonary diseaseStatins enhance the anti-inflammatory effects of inhaled corticosteroids in asthmatic patients through increased induction of indoleamine 2, 3-dioxygenaseMechanisms and resistance in glucocorticoid control of inflammationFunctional characterization of chicken glucocorticoid and mineralocorticoid receptorsАктивность нейтрофильной эластазы сыворотки крови у больных атопической бронхиальной астмойEffects of glucocorticoids on the neutrophil count: A cohort study among hospitalized patientsEvidence for Adverse Phonatory Change Following an Inhaled Combination TreatmentTargeting Th2 Cells in Asthmatic AirwaysIdentification of exacerbations in obstructive lung disease through biomarkersHistone deacetylase-2 and airway diseaseThe K + channels K Ca 3.1 and K v 1.3 as novel targets for asthma therapyThe Asthmatic Patient and CM-Induced Adverse ReactionsRescue Treatment in AsthmaGlucocorticoid resistance in inflammatory diseasesEffector T cells control lung inflammation during acute influenza virus infection by producing IL-10Association between CRHR1 polymorphism and improved lung function in response to inhaled corticosteroid in patients with COPDRole of HDAC2 in the Pathophysiology of COPDIntroduction to Signalling CascadesStatus AsthmaticusCorticosteroidsFuture TherapiesASTHMA AND CHRONIC OBSTRUCTIVE PULMONARY DISEASEPrehospital pharmacological interventions in acute asthma: A rationale for useInhaled corticosteroids as rescue medication in acute severe asthmaMAPK phosphatases as novel targets for rheumatoid arthritisAsthma: Eosinophil Disease, Mast Cell Disease, or Both?Anti-proliferative and anti-remodelling effect of beclomethasone dipropionate, formoterol and salbutamol alone or in combination in primary human bronchial fibroblastsThe JAK-3 inhibitor CP-690550 is a potent anti-inflammatory agent in a murine model of pulmonary eosinophiliaTreatment strategies for allergy and asthmaInhaled corticosteroid prevents the thickening of airway smooth muscle in murine model of chronic asthmaZijn inhalatiecorticosteroïden minder werkzaam bij patiënten die (door)roken?Advances Toward Dissociated Non-Steroidal Glucocorticoid Receptor AgonistsSputum indoleamine-2, 3-dioxygenase activity is increased in asthmatic airways by using inhaled corticosteroidsThree Generations of Ongoing Controversies Concerning the Use of Short Acting Beta-Agonist Therapy in Asthma: A ReviewComparison of kinin B1 and B2 receptor expression in neutrophils of asthmatic and non-asthmatic subjectsAltered phosphorylated signal transducer and activator of transcription profile of CD4+CD161+ T cells in asthma: Modulation by allergic status and oral corticosteroidsGlucocorticoid and Sex Hormone Receptors: Clinical Implications and Therapeutic RelevanceChemokines and their receptors as potential targets for the treatment of asthmaVariable p-CREB expression depicts different asthma phenotypesLoss of Control of Asthma Following Inhaled Corticosteroid Withdrawal Is Associated With Increased Sputum Interleukin-8 and NeutrophilsThe influence of corticosteroids on the perception of dyspnea in asthmaInhaled steroids are associated with reduced lung function decline in subjects with asthma with elevated total IgEGlucocorticosteroids for AsthmaEvaluation of the anti-inflammatory efficacy of Passiflora edulisDexamethasone Alters Bronchoalveolar Lavage Fluid Proteome in a Mouse Asthma ModelEpigenetics and airways diseaseNew therapies for asthmaRisks of glucocorticoid treatment—are they related to treatment duration and dosage?Rapid Effects of Inhaled Corticosteroids in Acute AsthmaInhaled Corticosteroids in the Treatment of Asthma Exacerbations: Essential ConceptsCollagen impairs glucocorticoid actions in airway smooth muscle through integrin signallingConceptos básicos sobre la utilización de corticoides inhalados en el tratamiento de la exacerbación asmáticaGlycyrrhizin alleviates experimental allergic asthma in miceAntiinflammatory effects of Tacrolimus in a mouse model of pleurisyMacrophage migration inhibitory factor and glucocorticoid sensitivityTreating Asthma as an Inflammatory DiseaseHow corticosteroids control inflammation: Quintiles Prize Lecture 2005Differential role of MAPK signaling in human dendritic cell maturation and Th1/Th2 engagementIncreased levels of BAL cysteinyl leukotrienes in acute RSV bronchiolitisIncreased Glucocorticoid Receptor β Alters Steroid Response in Glucocorticoid-insensitive AsthmaCorticosteroids: The drugs to beatUpdate on glucocorticoid action and resistanceEffect of Beclomethasone Dipropionate and Dexamethasone Isonicotinate on Lung Function, Bronchoalveolar Lavage Fluid Cytology, and Transcription Factor Expression in Airways of Horses with Recurrent Airway ObstructionCORTICOSTEROIDS | Glucocorticoid ReceptorsCORTICOSTEROIDS | TherapyTRANSCRIPTION FACTORS | OverviewBiology and Assessment of Airway InflammationNovel signal transduction modulators for the treatment of airway diseasesDrugs for asthmaGlucocorticoids: exemplars of multi-taskingReduced Histone Deacetylase in COPDCorticosteroid Insensitivity in Smokers??with??AsthmaNew and improved glucocorticoid receptor ligandsCardiovascular-related proteins identified in human plasma by the HUPO Plasma Proteome Project Pilot PhaseMolecular Mechanisms and Cellular Effects of GlucocorticosteroidsNebennierenrinde und SteroideWill it be steroids for ever?Corticothérapie inhalée : un traitement à impacts multiplesComparison of Inhaled Fluticasone with Intravenous Hydrocortisone in the Treatment of Adult Acute AsthmaThe influence of smoking on the treatment response in patients with asthmaGlucocorticoids suppress transcriptional up-regulation of bradykinin receptors in a murine in vitro model of chronic airway inflammationMitogen-activated protein kinases and asthmaTherapeutic administration of Budesonide ameliorates allergen-induced airway remodellingThe influence of smoking on the treatment response in patients with asthmaComparison Study between the Mechanisms of Allergic Asthma Amelioration by a Cysteinyl-Leukotriene Type 1 Receptor Antagonist Montelukast and MethylprednisoloneDifferential Regulation of Chemokine Expression by Peroxisome Proliferator-activated Receptor γ AgonistsHistone Deacetylation: An Important Mechanism in Inflammatory Lung DiseasesRedox Regulation of Histone Deacetylases and Glucocorticoid-Mediated Inhibition of the Inflammatory ResponseGlucocorticoids for Human Skin: New Aspects of the Mechanism of ActionAnti-Tissue Remodeling Effects of CorticosteroidsInhaled Corticosteroids in Chronic Obstructive Pulmonary DiseaseThe size of the problem of managing asthmaNew drugs for asthma“Refractory” Eosinophilic Airway Inflammation in Severe AsthmaEditorial III: Corticosteroids for septic shock—a standard of care?Corticosteroid resistance in chronic obstructive pulmonary disease: inactivation of histone deacetylaseOxidative Stress in COPDThe Role of Oxidative Stress in Chronic Obstructive Pulmonary DiseaseCombination Therapy of Long-Acting ??2-Adrenoceptor Agonists and Corticosteroids for AsthmaDrugs for airway diseaseDrugs for the treatment of asthma and COPDCorticosteroid TherapyImpact of Tobacco Smoke on Asthma and Allergic Disease 2 September 2003Volume 139, Issue 5_Part_1Page: 359-370KeywordsAsthmaCellsCytokinesDNAEnzymesHistonesInflammationProteinsSteroid resistanceTranscription factors ePublished: 2 September 2003 Issue Published: 2 September 2003 CopyrightCopyright © 2003 by American College of Physicians. 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