New approaches to anti-inflammatory therapy for asthma

Currently, corticosteroids are the therapy of choice for the inflammatory component of asthma. This class of drug provides powerful anti-inflammatory effects in most patients; however, these effects are not specific and in some cases may result in serious side effects. Also, many patients have difficulty adhering to therapy with inhaled forms of these drugs, which are administered by metered-dose inhalers up to several times per day. There are several other therapies that provide potential anti-inflammatory effects, but they are of low efficacy, with little definitive anti-inflammatory effect. While efforts are currently under way to improve corticosteroid therapy, other directions include the development of targeted anti-inflammatory agents. For example, the leukotrienes, a family of inflammatory mediators that have been shown to enhance bronchoconstriction and airway mucus secretion, have been the focus of numerous investigations. Specific leukotriene receptor antagonists and synthesis inhibitors have been developed and are currently showing promise in clinical trials; one leukotriene receptor antagonist (zafirlukast) and one 5-lipoxygenase inhibitor (zileuton) were recently approved by the United States Food and Drug Administration for the treatment of asthma.