Abstract

CLINICAL PHARMACOLOGY OF GLUCOCORTICOIDS FOR ASTHMA TREATMENT.

Maithili Gangadharrao Aage* and Prof. Dr. Mahalaxmi Mohan

ABSTRACT

Glucocorticoids are the most effective treatment for asthma. However, their clinical applications are limited by low efficacy in severe asthma and by undesired side effects associated with high dose or prolonged use. The most successful approach to overcome these limitations has been the development of highly potent glucocorticoids that can be delivered to the lungs by inhalation to achieve local efficacy with minimal systemic effects. (He, Shi, & Gao, 2015). Corticosteroids have numerous applications in treating inflammation and diseases of immune function based on their significant anti-inflammatory and immunosuppressive effects. Corticosteroids modulate immune function through various effects in the nucleus of numerous cells. When used in pharmacologic doses to suppress allergic responses or inflammation, these agents can cause numerous adverse effects associated with an excess of glucocorticoid activity. (Williams, 2018). Glucocorticosteroids are the first-line therapy for controlling airway inflammation in asthma. They bind intra-cellular glucocorticoid receptors to trigger increased expression of anti-inflammatory genes and suppression of pro-inflammatory gene activation in asthmatic airways. In the majority of asthma patients, inhaled glucocorticoids are clinically efficacious, improving lung function and preventing exacerbations. However, 5–10 % of the asthmatic population respond poorly to high dose inhaled and then systemic glucocorticoids. These patients form a category of severe asthma associated with poor quality of life, increased morbidity and mortality, and constitutes a major societal and health care burden. (Henderson & Maffia, 2020). Synthetic glucocorticoids, such as prednisone, are among the most widely prescribed drugs worldwide and are used to treat many acute and chronic inflammatory conditions. The current paradigm of glucocorticoid efficacy is that they are potent anti-inflammatory agents. (Freishtat, Nagaraju, & Jusko, 2012).

Keywords: Asthma, Glucocorticoids, Inflammation.