Advances in combination therapy for asthma and COPD by Jan Lotvall

By Jan Lotvall

content material: Similarities and adjustments within the pathophysiology of bronchial asthma and COPD / Christian Virchow --
Glucocorticoids : pharmacology and mechanisms / Peter Barnes --
Inhaled corticosteroids? medical results in bronchial asthma and COPD / Paul O'Byrne --
LABAS : pharmacology, mechanisms and interplay with anti inflammatory remedies / Gary Anderson --
lengthy and ultra-long performing beta-2-agonists / Mario Cazzola --
the protection of long-acting beta agonists and the improvement of mix remedies for bronchial asthma and persistent obstructive pulmonary illness / Eugene Bleecker --
Inhaled mix treatment with glucocorticoids and long-acting beta-2-agonists in bronchial asthma and COPD, present and destiny views / Jan Lotvall --
Novel anti inflammatory remedies for bronchial asthma and COPD / Ian Adcock --
Novel biologicals by myself and together in bronchial asthma and allergic reaction / William Busse --
Anti-infective remedies in bronchial asthma and COPD / Jonathan D.R. Macintyre & Sebastian L. Johnston --
lengthy appearing muscarinic antagonists in bronchial asthma and COPD / Denis O'Donnell --
Phosphodiesterase inhibitors in obstructive lung sickness / Jan Lotvall --
organic remedies in improvement for COPD / Riccardo Polosa --
Triple therapy?, within the administration of persistent obstructive lung disorder (COPD). the worth of mixture remedy with inhaled steroid, lengthy appearing anticholinergicbronchodilator and lengthy performing beta 2 agonist bronchodilator in COPD / Ronald Dahl.

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A similar mechanism may operate in severe asthma where increased oxidative stress is generated by airway inflammation. 8). Steroid resistance in COPD Although inhaled glucocorticoids are highly effective in asthma, they provide relatively little therapeutic benefit in COPD, despite the fact that active airway and lung inflammation is present. This may reflect the fact that the inflammation in COPD is not suppressed by glucocorticoids, with no reduction in inflammatory cells, cytokines or proteases in induced sputum even with oral glucocorticoids.

21 Anti-inflammatory gene activation Several of the genes that are switched on by glucocorticoids have anti-inflammatory effects, including annexin-1 (lipocortin-1), secretory leukoprotease inhibitor (SLPI), interleukin-10 and inhibitor of NF-␬B (I␬B-␣). 25 However, it seems unlikely that the widespread anti-inflammatory actions of glucocorticoids could be entirely explained by increased transcription of small numbers of anti-inflammatory genes, particularly as high concentrations of glucocorticoids are usually required for this effect, whereas in clinical practice glucocorticoids are able to suppress inflammation at low concentrations.

Post-transcriptional regulation of proinflammatory proteins. J Leukoc Biol 2004;76:42–7. 35. Dean JL, Sully G, Clark AR, Saklatvala J. The involvement of AU-rich element-binding proteins in p38 mitogen-activated protein kinase pathway-mediated mRNA stabilisation. Cell Signal 2004;16:1113–21. 36. Bergmann M, Barnes PJ, Newton R. Molecular regulation of granulocyte macrophage colonystimulating factor in human lung epithelial cells by interleukin (IL)-1␤, IL-4, and IL-13 involves both transcriptional and post-transcriptional mechanisms.

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