A Guide to Inhaled Corticosteroids for Asthma Management

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Published: May 31, 2023
Keywords:
Inhaled corticosteroids (ICS) are the most effective controllers for the treatment of asthma. Inhaled corticosteroids are the most effective controllers for the long-term treatment of asthma; they suppress inflammation in asthma, reducing symptoms and exacerbations, and preventing fixed airflow obstruction and chronic airway remodeling. Inhaled corticosteroids reduce the multiple activated inflammatory genes in asthma by switching off through the recruitment of histone deacetylase 2 by the activated glucocorticoid receptor. This is associated with a reversal of histone acetylation and with suppression of activated inflammatory genes such as interleukin-8 and inducible nitric oxide synthase with prevention of recruitment of inflammatory cells in asthma. Treatment with inhaled corticosteroids added to as-needed short-acting β2 -agonists, in a similar dose response, reduces airway hyperresponsiveness, an early and characteristic feature of asthma, as well as controlling asthma symptoms.

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Fahd Jubran Alqahtani, Turki Fahad Turki Alqahtani

Abstract

Inhaled corticosteroids (ICS) are the most effective controllers of asthma and are also used to treat many other chronic inflammatory diseases that affect the bronchial mucosa, such as chronic obstructive pulmonary disease and rhinitis. ICS switch off multiple activated inflammatory genes through transcriptional control of all of these genes and also through reversing histone acetylation, which is achieved through recruitment of histone deacetylase 2 (HDAC2) to the activated inflammatory gene complex. This is initiated by the corticosteroid binding to the glucocorticoid receptor-alpha, which rapidly enters the cell nucleus, such as with the activated inflammatory gene macrophage migration inhibitory factor (MIF) gene in asthma.

Article Details

Issue
Vol. 47 No. 2 (2023)
Section
Articles