Ricciardolo Fabio L M
Unit of Pulmonary Disease, IRCCS G. Gaslini Institute, Largo G. Gaslini, 5, 16147 Genoa, Italy.
Pulm Pharmacol Ther. 2007;20(5):473-82. doi: 10.1016/j.pupt.2005.11.007. Epub 2005 Dec 13.
The evidence that asthma is characterized by extensive inflammation of the airways has warranted the use of inhaled corticosteroid (ICS) in asthma maintenance therapy. Corticosteroid treatment, especially if high or frequent doses are required, is associated with a range of adverse effects including adrenal suppression and impairment in growth and bone metabolism. New corticosteroids are in development, including mometasone furoate, and some of these are predicted to have reduced adverse effects such as the soft steroid ciclesonide. Soft steroids are designed for delivery near to their site of action, to exert their effect and then to undergo controlled and predictable metabolism to inactive metabolites. This review points out the anti-inflammatory effects of corticosteroid in asthmatic airways and the clinical efficacy and safety of ICS in asthmatic children. The development of a soft steroid should help to achieve the aim of improving the therapeutic profile of ICS in asthma and thus alleviate the ongoing problem of poor patient compliance especially in childhood.
有证据表明哮喘的特征是气道广泛炎症，这使得吸入性糖皮质激素（ICS）被用于哮喘维持治疗。糖皮质激素治疗，尤其是在需要高剂量或频繁给药时，会带来一系列不良反应，包括肾上腺抑制以及生长和骨代谢受损。新型糖皮质激素正在研发中，包括糠酸莫米松，其中一些预计不良反应会减少，如软性激素环索奈德。软性激素旨在作用部位附近给药，发挥作用后进行可控且可预测的代谢，生成无活性的代谢产物。本综述指出了糖皮质激素在哮喘气道中的抗炎作用以及ICS在哮喘儿童中的临床疗效和安全性。软性激素的研发应有助于实现改善ICS在哮喘治疗中的疗效这一目标，从而缓解患者尤其是儿童依从性差这一持续存在的问题。
