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Nuevos objetivos para el desarrollo de fármacos en el asma
Ian M Adcock1, Gaetano Caramori, K Fan Chung
1Airways Disease Section, National Heart and Lung Institute, Imperial College London, London, UK.
Lancet (London, England)
|September 23, 2008
Resumen
El asma afecta a 300 millones de personas en todo el mundo, y entre el 5 y el 10% tiene una enfermedad grave y difícil de tratar. Las terapias futuras se dirigirán a vías inflamatorias específicas para el manejo personalizado del asma.
Área de la Ciencia:
- Pulmonología Pulmonología.
- Inmunología Inmunología.
- Farmacología Farmacología.
Sus antecedentes:
- El asma es una enfermedad inflamatoria crónica de las vías respiratorias que afecta a 300 millones de personas en todo el mundo, y se prevé que aumente.
- Si bien la mayoría de los pacientes responden a los corticosteroides inhalados y a los beta-agonistas, entre el 5 y el 10% tienen asma grave y refractaria.
- Los avances en la comprensión de los fenotipos del asma revelan perfiles inflamatorios distintos, guiando terapias dirigidas como los antileucotrienos y el omalizumab.
Objetivo del estudio:
- Revisar los conocimientos actuales sobre la fisiopatología del asma y los mecanismos inflamatorios.
- Discutir estrategias terapéuticas emergentes dirigidas a vías y mediadores específicos.
- Explorar el potencial de la medicina personalizada en el tratamiento del asma grave.
Principales métodos:
- Revisión de la literatura sobre la fisiopatología, los fenotipos y los avances en el tratamiento del asma.
- Análisis de agentes terapéuticos actuales y en investigación.
- Discusión de las direcciones futuras en la investigación del asma y el manejo clínico.
Principales resultados:
- Reconocimiento de distintos fenotipos de asma vinculados a tipos específicos de inflamación.
- Identificación de nuevos objetivos terapéuticos, incluidos p38 MAPK, antioxidantes, IL-13 y células inmunorreguladoras.
- El potencial de las terapias combinadas para superar la insensibilidad a los corticosteroides en el asma grave.
Conclusiones:
- Una mayor investigación sobre los mecanismos de inflamación de las vías respiratorias es crucial para mejorar las terapias contra el asma.
- El desarrollo de terapias dirigidas y tratamientos combinados es prometedor para el manejo del asma grave.
- Las estrategias de tratamiento personalizadas basadas en distintos subtipos de asma son un objetivo futuro, aunque una cura sigue siendo distante.
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