Corticosteroid unresponsiveness in asthma: Primary or acquired?

Caerulomycin A inhibits Th2 cell activity: a possible role in the management of asthma

“…Consequently, we started the current study since our preliminary experiments suggested that CaeA can efficiently suppress the Th2 response 19 . Further, many patients suffering from asthma either does not respond to the existing drugs or become refractory to them 9 10 . Accordingly, to overcome this problem, it becomes an urgent need to discover newer drugs.…”

“…Despite the availability of numerous drugs, corticosteroids are most widely used for the treatment of asthma. Despondently, some individuals do not respond to the existing therapies 9 10 . Th2 response is known to induce glucocorticoid resistance 11 .…”

Management of severe asthma in children

“…Congenital steroid resistance from mutations in the corticosteroid receptor is rare. 107 Acquired steroid resistance can extend over a range and can be overcome by high doses, albeit at the risk of increased side-effects. There are many potential mechanisms of steroid resistance, 108,109 but these have been studied mostly in adults and the relevance in children is not clear.…”

Invasive monitoring of airway inflammation

“…Thus, biopsy evidence of steroid‐resistant eosinophilic inflammation in a symptomatic child would support use of an agent such as methotrexate or cyclosporin. On the other hand, a patient whose biopsy shows neutrophilic inflammation might be given a long‐acting β‐agonist or continuous subcutaneous terbutaline 4 , 13 . ‐ 15 This approach may be correct, but the lack of longitudinal data means that its appropriateness in children remains to be established.…”