University of Campania "Luigi Vanvitelli", Department of Experimental Medicine, Naples, Italy.
University of Rome "Tor Vergata", Department of Experimental Medicine, Rome, Italy.
Pulm Pharmacol Ther. 2019 Oct;58:101828. doi: 10.1016/j.pupt.2019.101828. Epub 2019 Jul 23.
The differences in the pharmacokinetic (PK) characteristics of inhaled corticosteroids (ICSs) critically influence the profile of each of them, but also the significant differences in glucocorticoid receptor selectivity, potency, and physicochemical properties are critical in defining the pharmacodynamic (PD) profile of an ICS. The PK and PD properties of ICSs used in asthma and the importance of their interrelationship have been reviewed. The differences among the ICSs in PK and PD must be considered when an ICS should be prescribed to an asthmatic patient because a better understanding of the PK/PD interrelationship of ICSs could be important to better fit with the between-patient variability and within-patient repeatability in the response to ICSs that often complicate the therapeutic approach to the asthmatic patient. The role of the device in influencing the PK profile of an ICS must be always considered because it is crucial. Also patient-related factors and disease severity affect pulmonary deposition of ICS.
吸入性皮质类固醇（ICS）的药代动力学（PK）特征差异会极大地影响它们各自的特征，而糖皮质激素受体选择性、效力和理化特性的显著差异则对 ICS 的药效学（PD）特征具有决定性影响。本文回顾了哮喘中使用的 ICS 的 PK 和 PD 特性，以及它们相互关系的重要性。当为哮喘患者开处方时，必须考虑 ICS 的 PK 和 PD 之间的差异，因为更好地了解 ICS 的 PK/PD 相互关系可能有助于更好地适应 ICS 反应中的患者间变异性和患者内可重复性，而这常常使哮喘患者的治疗方法复杂化。影响 ICS PK 特征的装置的作用必须始终被考虑，因为这是至关重要的。此外，患者相关因素和疾病严重程度会影响 ICS 的肺部沉积。
