Inhaled Corticosteroids

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Title: Inhaled Corticosteroids
Author(s): Barnes, PJ
Item Type: Journal Article
Abstract: Inhaled corticosteroids (ICS) are the most effective controllers of asthma. They suppress inflammation mainly by switching off multiple activated inflammatory genes through reversing histone acetylation via the recruitment of histone deacetylase 2 (HDAC2). Through suppression of airway inflammation ICS reduce airway hyperresponsiveness and control asthma symptoms. ICS are now first-line therapy for all patients with persistent asthma, controlling asthma symptoms and preventing exacerbations. Inhaled long-acting β₂-agonists added to ICS further improve asthma control and are commonly given as combination inhalers, which improve compliance and control asthma at lower doses of corticosteroids. By contrast, ICS provide much less clinical benefit in COPD and the inflammation is resistant to the action of corticosteroids. This appears to be due to a reduction in HDAC2 activity and expression as a result of oxidative stress. ICS are added to bronchodilators in patients with severe COPD to reduce exacerbations. ICS, which are absorbed from the lungs into the systemic circulation, have negligible systemic side effects at the doses most patients require, although the high doses used in COPD has some systemic side effects and increases the risk of developing pneumonia.
Publication Date: 8-Mar-2010
Date of Acceptance: 2-Mar-2010
ISSN: 1424-8247
Publisher: MDPI
Start Page: 514
End Page: 540
Journal / Book Title: Pharmaceuticals
Volume: 3
Issue: 3
Copyright Statement: This is an open access article distributed under the Creative Commons Attribution License (CC BY 3.0).
Keywords: eosinophil
epithelial cell
glucocorticoid receptor
histone deacetylase
inflammatory gene
long-acting β2-agonist
nuclear factor-κB
1115 Pharmacology And Pharmaceutical Sciences
Publication Status: Published
Appears in Collections:National Heart and Lung Institute
Airway Disease
Faculty of Medicine

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