Glucocorticoids: Clinical Pharmacology

Spahn, Joseph D.; Covar, Ronina; Szefler, Stanley J.

doi:10.1016/b978-0-323-05659-5.00089-9

Middleton's Allergy: Principles and Practice 2009

DOI: 10.1016/b978-0-323-05659-5.00089-9

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Glucocorticoids: Clinical Pharmacology

Joseph D. Spahn¹,

Ronina Covar²,

Stanley J. Szefler³

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2010

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“…Since that time vast experience has been gained and a huge body of literature has been developed in this area. [ 9 ] Systemic glucocorticoids are mainly used to treat acute asthma exacerbations. On the other hand, inhaled glucocorticoids either in dry powder form or as metered-dose inhaler (MDI) are used as daily-maintenance therapy to control asthma symptoms and prevent exacerbations.…”

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confidence: 99%

Genomic and non-genomic actions of glucocorticoids in asthma

Alangari¹

2010

Ann Thorac Med

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Glucocorticoids are the mainstay of asthma therapy. They are primarily used to suppress airway inflammation, which is the central pathological change in asthmatic patients’ airways. This is achieved by many different mechanisms. The classical mechanism is by suppression of the genetic transcription of many inflammatory cytokines that are key in asthma pathophysiology (transrepression). On the other hand, the transcription of certain inhibitory cytokines is activated by glucocorticoids (transactivation), a mechanism that also mediates many of the adverse effects of glucocorticoids. The onset of action through these mechanisms is often delayed (4-24 hours). Other mechanisms mediated through non-genomic pathways are increasingly appreciated. These are delivered in part by binding of glucocorticoids to nonclassical membrane-bound glucocorticoid receptors or by potentiating the α1-adrenergic action on the bronchial arterial smooth muscles, in addition to other mechanisms. These effects are characterized by their rapid onset and short duration of action. Understanding these different mechanisms will help in the development of new and better drugs to treat this common disease and to develop new improved strategies in our approach to its management. Here, the genomic and non-genomic mechanisms of actions of glucocorticoids in asthma are briefly reviewed, with special emphasis on the current updates of the non-genomic mechanisms.

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confidence: 99%

Genomic and non-genomic actions of glucocorticoids in asthma

Alangari¹

2010

Ann Thorac Med

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Glucocorticoids: Clinical Pharmacology

Cited by 1 publication

References 92 publications

Genomic and non-genomic actions of glucocorticoids in asthma

Genomic and non-genomic actions of glucocorticoids in asthma

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