Addressing corticosteroid insensitivity in adults with asthma

Thomson, N. C. (2016) Addressing corticosteroid insensitivity in adults with asthma. Expert Review of Respiratory Medicine, 10(2), pp. 137-156. (doi: 10.1586/17476348.2016.1133304) (PMID:26678267)

Abstract

Corticosteroids are the most effective treatment for asthma, but the therapeutic response varies markedly between individuals, with up to one third of patients showing evidence of insensitivity to corticosteroids. This article summarizes information on genetic, environmental and asthma-related factors as well as demographic and pharmacokinetic variables associated with corticosteroid insensitivity in asthma. Molecular mechanisms proposed to explain corticosteroid insensitivity are reviewed including alterations in glucocorticoid receptor subtype, binding and nuclear translocation, increased proinflammatory transcription factors and defective histone acetylation. Current therapies and future interventions that may restore corticosteroid sensitivity in asthma are discussed, including small molecule drugs and biological agents. In the future, biomarkers may be used in the clinic to predict corticosteroid sensitivity in patients with poorly controlled asthma.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Thomson, Professor Neil
• Authors: Thomson, N. C.
• College/School: College of Medical Veterinary and Life Sciences > School of Infection & Immunity
• Journal Name: Expert Review of Respiratory Medicine
• Publisher: Taylor and Francis
• ISSN: 1747-6348
• ISSN (Online): 1747-6356
• Published Online: 17 December 2015
• Copyright Holders: Copyright © 2015 Taylor and Francis
• First Published: First published in Expert Review of Respiratory Medicine 10(2):137-156
• Publisher Policy: Reproduced in accordance with the copyright policy of the publisher