everhealthy
02-03-2005, 08:42 PM
Five million adult asthmatics may have predominantly neutrophilic inflammation. Whilst this phenotype is usually associated with severe asthma, it may be more prevalent across the range of disease severities than originally thought. The emergence of this phenotype in asthma raises important implications for treatment practice.
Severe asthma is a term that encompasses patients with a steroid-resistant, irreversible, refractory, brittle, near fatal and difficult-to-control or poorly controlled condition. Both genetic and environmental elements are likely to play an important role in the development of severe disease, although it is unclear what is the most important factor in its development.
Although many asthmatics have been severely affected for most of their lives, there appears to be a group of mainly female, non-atopic adults that develop severe disease in adulthood. The European Network for Understanding Mechanisms of Severe Asthma (ENFUMOSA) found that, in patients aged 17-65 years of age, severe asthma was 2.8 times more common in females than males.
A vital outcome of this study was that it demonstrated for the first time that patients who are steroid-naive can also present with predominantly neutrophilic airway inflammation. Inhaled corticosteroids are thought to prolong neutrophil survival by inhibition of apoptosis, hence the presence of neutrophils in severe asthma may reflect treatment with high doses of corticosteroids (although the extent to which they genuinely potentiate neutrophil activity is far from clear). The fact that steroid-naive patients also demonstrate neutrophilic inflammation may provide a mechanism by which subjects evolve into more severe cases.
Read details at: http://www.pharmaceutical-business-review.com/article_feature.asp?guid=125C3DB1-7A51-44AD-932A-46DEB2384A2F
Severe asthma is a term that encompasses patients with a steroid-resistant, irreversible, refractory, brittle, near fatal and difficult-to-control or poorly controlled condition. Both genetic and environmental elements are likely to play an important role in the development of severe disease, although it is unclear what is the most important factor in its development.
Although many asthmatics have been severely affected for most of their lives, there appears to be a group of mainly female, non-atopic adults that develop severe disease in adulthood. The European Network for Understanding Mechanisms of Severe Asthma (ENFUMOSA) found that, in patients aged 17-65 years of age, severe asthma was 2.8 times more common in females than males.
A vital outcome of this study was that it demonstrated for the first time that patients who are steroid-naive can also present with predominantly neutrophilic airway inflammation. Inhaled corticosteroids are thought to prolong neutrophil survival by inhibition of apoptosis, hence the presence of neutrophils in severe asthma may reflect treatment with high doses of corticosteroids (although the extent to which they genuinely potentiate neutrophil activity is far from clear). The fact that steroid-naive patients also demonstrate neutrophilic inflammation may provide a mechanism by which subjects evolve into more severe cases.
Read details at: http://www.pharmaceutical-business-review.com/article_feature.asp?guid=125C3DB1-7A51-44AD-932A-46DEB2384A2F