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Correction: Jiménez-Sánchez et al. Antioxidant Enzymes Genetic Variants Associated with Urticaria/Angioedema Induced by Cross-Reactive Hypersensitivity to Nonsteroidal Anti-Inflammatory Drugs. <i>Pharmaceuticals</i> 2026, <i>19</i>, 522.

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Inhaled Corticosteroids.

Peter J Barnes1

  • 1National Heart and Lung Institute, Imperial College, London, UK. p.j.barnes@imperial.ac.uk.

Pharmaceuticals (Basel, Switzerland)
|October 8, 2016
PubMed
Summary
This summary is machine-generated.

Inhaled corticosteroids (ICS) effectively control asthma by reducing airway inflammation. However, their benefit is limited in COPD due to corticosteroid-resistant inflammation, linked to reduced histone deacetylase 2 (HDAC2) activity.

Keywords:
eosinophilepithelial cellglucocorticoid receptorhistone deacetylaseinflammationinflammatory genelong-acting β2-agonistnuclear factor-κBpneumonia

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Area of Science:

  • Pulmonology
  • Pharmacology

Background:

  • Inhaled corticosteroids (ICS) are the primary treatment for persistent asthma, effectively managing symptoms and preventing exacerbations.
  • ICS function by suppressing airway inflammation through histone deacetylase 2 (HDAC2)-mediated gene regulation.

Approach:

  • This review examines the mechanism of ICS in asthma and COPD.
  • It highlights the reduced efficacy of ICS in COPD, attributing it to oxidative stress-induced downregulation of HDAC2.
  • The role of combination inhalers with long-acting β₂-agonists in improving asthma control is also discussed.

Key Points:

  • ICS are highly effective in asthma by reversing histone acetylation and reducing airway hyperresponsiveness.
  • In COPD, inflammation is largely resistant to corticosteroids due to decreased HDAC2 activity.
  • ICS are used in severe COPD to reduce exacerbations, despite potential systemic side effects at higher doses.

Conclusions:

  • ICS remain the cornerstone of persistent asthma management.
  • Strategies to overcome corticosteroid resistance in COPD are needed.
  • While generally safe, ICS carry risks of systemic side effects and pneumonia, particularly at high doses used in COPD.