Kandeel M, Balaha M, Inagaki N, Kitade Y
Department of Pharmacology, Kafrelshiekh University, Kafrelshiekh, Egypt.
Drugs Today (Barc). 2013 May;49(5):325-39. doi: 10.1358/dot.2013.49.5.1950149.
Corticosteroids (CST) are the gold standard for asthma management and for several decades have been considered the cornerstone for asthma control. With the recent advent of genomic and structural analysis technologies, the molecular basis of the side effects, toxicity and resistance mechanisms of drug treatment are better understood. With respect to CST, there is consistent evidence that while CST therapy improves asthma symptoms, it does not alter the natural course of asthma or offer clear long-lasting improvement of respiratory performance. Therefore, the development of drugs capable of minimizing or avoiding CST side effects, toxicity and resistance could be the way forward for establishing new asthma therapies. This review summarizes the molecular basis of corticosteroid mechanisms of action and the related mechanisms influencing side effects and resistance. The future of CST adjunctive or replacement therapy is also briefly discussed.
皮质类固醇（CST）是哮喘管理的金标准，几十年来一直被视为哮喘控制的基石。随着基因组和结构分析技术的最新出现，药物治疗的副作用、毒性和耐药机制的分子基础得到了更好的理解。关于CST，有一致的证据表明，虽然CST疗法可改善哮喘症状，但它不会改变哮喘的自然病程，也不能带来呼吸功能的明显持久改善。因此，开发能够最小化或避免CST副作用、毒性和耐药性的药物可能是建立新的哮喘治疗方法的前进方向。本综述总结了皮质类固醇作用机制的分子基础以及影响副作用和耐药性的相关机制。还简要讨论了CST辅助或替代疗法的未来。
