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Glucocorticoid-resistant asthma: pathogenesis and clinical implications for management
1Dept of Pediatrics, National Jewish Center for Immunology and Respiratory Medicine, Denver, Colorado 80206, USA.
The European Respiratory Journal
|July 1, 1997
Summary
This review explores glucocorticoid-resistant asthma, a challenging condition where standard anti-inflammatory treatments fail. Understanding persistent inflammation mechanisms is key to improving asthma management and identifying new therapeutic targets.
Area of Science:
- Pulmonology
- Allergy and Immunology
- Pharmacology
Background:
- Asthma is primarily viewed as chronic airway inflammation, often linked to allergen hypersensitivity.
- Management typically involves environmental control and anti-inflammatory therapies like inhaled glucocorticoids.
- A subset of patients exhibits difficult-to-control asthma despite high-dose glucocorticoid treatment.
Purpose of the Study:
- To review current understanding of glucocorticoid-resistant asthma.
- To explore mechanisms of persistent airway inflammation in refractory asthma.
- To discuss implications for clinical management and identify research gaps.
Main Methods:
- Literature review of current concepts in asthma management and glucocorticoid resistance.
- Synthesis of existing knowledge on mechanisms of persistent inflammation.
- Analysis of challenges in managing difficult-to-control asthma.
Main Results:
- Conventional asthma therapies are effective for most patients.
- Glucocorticoid resistance presents significant clinical management challenges.
- Questions remain regarding the role of allergen exposure and inherent patient characteristics in disease progression.
Conclusions:
- Further research is needed to understand glucocorticoid resistance and persistent inflammation.
- Identifying factors influencing glucocorticoid response is crucial for therapeutic intervention.
- Better understanding may reveal new targets for managing severe and refractory asthma.