[Cortisone-resistant bronchial asthma]

Ann Ital Med Int. 1996 Jul-Sep;11(3):187-95.
[Article in Italian]

Abstract

There is general agreement on the inflammatory pathogenesis of bronchial asthma: an accumulation of activated eosinophils, degranulated mast cells, T lymphocytes and in very severe forms, granulocytes has constantly been found in the bronchial mucosa. In allergic bronchial asthma, inflammation seems to be orchestrated predominantly by a subset of T lymphocytes, with a phenotype similar to the Th2 subset able to produce IL-4 and IL-5. Although corticosteroids are the most potent therapeutic agents used for this disease, their anti-inflammatory effect differs from patient to patient. Some criteria which can be used to define steroid-resistant bronchial asthma are listed here. This review analyzes various molecular alterations responsible for the deficient response to corticosteroid treatment observed in steroid-resistant bronchial asthmatic subjects. New knowledge on the mechanism of steroid resistance may have important implications for the treatment of chronic asthma and other diseases.

Publication types

  • English Abstract
  • Review

MeSH terms

  • Adrenal Cortex Hormones / therapeutic use*
  • Anti-Inflammatory Agents / therapeutic use
  • Asthma / drug therapy*
  • Asthma / immunology
  • Asthma / physiopathology
  • Cortisone / therapeutic use
  • Cytokines / biosynthesis
  • DNA / metabolism
  • Drug Resistance
  • Humans
  • In Vitro Techniques
  • Interleukin-4 / biosynthesis
  • Interleukin-5 / biosynthesis
  • Phenotype
  • Receptors, Steroid / analysis
  • Receptors, Steroid / metabolism
  • T-Lymphocytes / drug effects
  • T-Lymphocytes / immunology*

Substances

  • Adrenal Cortex Hormones
  • Anti-Inflammatory Agents
  • Cytokines
  • Interleukin-5
  • Receptors, Steroid
  • Interleukin-4
  • DNA
  • Cortisone