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A Component-resolved Diagnostic Approach for a Study on Grass Pollen Allergens in Chinese Southerners with Allergic Rhinitis and/or Asthma
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Glucocortiosteroid subsensitivity and asthma severity.

Manali Mukherjee1, Sarah Svenningsen, Parameswaran Nair

  • 1Department of Medicine, McMaster University & St Joseph's Healthcare, Hamilton, Ontario, Canada.

Current Opinion in Pulmonary Medicine
|November 2, 2016
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Summary
This summary is machine-generated.

Glucocorticosteroids (GCSs) are key asthma treatments, but reduced efficacy, termed GCS subsensitivity, is common. This review explores factors influencing GCS response and potential therapeutic strategies.

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Area of Science:

  • Immunology
  • Pulmonology
  • Pharmacology

Background:

  • Glucocorticosteroids (GCSs) are primary treatments for asthma-related inflammation.
  • Individual responses to GCSs vary significantly, even within specific asthma types.
  • Reduced GCS efficacy, known as GCS subsensitivity, arises from altered signaling pathways due to various factors.

Purpose of the Study:

  • To review current understanding of GCS subsensitivity in asthma.
  • To explore molecular and clinical insights into factors affecting GCS response.
  • To aid in developing therapeutic strategies for managing steroid-subsensitive asthma.

Main Methods:

  • Literature review of existing and emerging research on GCS subsensitivity.
  • Analysis of molecular mechanisms underlying GCS resistance.
  • Discussion of clinical observations and therapeutic implications.

Main Results:

  • Past associations include altered glucocorticoid receptor expression, neutrophilic inflammation, Th17 cytokines, and oxidative stress.
  • Recent findings highlight GCS effects on transcription factors, microRNAs, and the role of IL-10 in restoring response.
  • Emerging concepts involve autoimmunity from unresolved inflammation and lymphopenia as a GCS side effect.

Conclusions:

  • Understanding GCS subsensitivity requires integrating known and novel molecular and clinical data.
  • Focus on pathways like PI3 kinase is crucial for optimizing asthma management.
  • Tailored therapeutic strategies are needed for patients with varying GCS sensitivity and disease severity.