Download Advances in combination therapy for asthma and COPD by Jan Lotvall PDF

By Jan Lotvall

content material: Similarities and transformations 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 blend remedies for bronchial asthma and protracted obstructive pulmonary sickness / Eugene Bleecker --
Inhaled mixture 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 hypersensitivity / 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 cures in improvement for COPD / Riccardo Polosa --
Triple therapy?, within the administration of persistent obstructive lung disorder (COPD). the worth of mixture therapy with inhaled steroid, lengthy appearing anticholinergicbronchodilator and lengthy performing beta 2 agonist bronchodilator in COPD / Ronald Dahl.

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5 Glucocorticoid receptors Glucocorticoids diffuse readily across cell membranes and bind to glucocorticoid receptors (GR) in the cytoplasm. 17 The receptor GR␣ binds glucocorticoids whereas GR␤ is an alternatively spliced form that binds to DNA but cannot be activated by glucocorticoids. GR␤ has a very low level of expression compared to GR␣. 19 For example, there are a number of serine/threonines P1: OTA/XYZ JWST083-02 P2: ABC JWST083-L¨otvall September 8, 2011 0:41 Printer Name: Yet to Come GLUCOCORTICOIDS: PHARMACOLOGY AND MECHANISMS 21 in the N-terminal domain where glucocorticoid receptors may be phosphorylated by various kinases.

Inhaled corticosteroids are the preferred route to treat airway diseases because of the availability of topically potent corticosteroids, which are very effective and have a far more favourable side-effect profile than systemically administered corticosteroids. Toogood et al. 8 These studies suggest that, in patients with moderate to severe asthma, inhaled corticosteroids, such as beclometasone dipropionate (BDP) or budesonide,9 are as effective as much higher doses of oral corticosteroids, with much less risk of systemic side effects.

66 As discussed above, glucocorticoids increase the gene transcription of ␤2 -receptors, resulting in increased expression of cell surface receptors. 69 This may be important for the non-bronchodilator effects of ␤2 -agonists, such as mast cell stabilization. 70 There is also evidence that ␤2 -agonists may affect GR and thus enhance the antiinflammatory effects of glucocorticoids. 72 This suggests that ␤2 -agonists and glucocorticoids enhance each other’s beneficial effects in asthma therapy. 10 Conclusions There is now a much better understanding of how glucocorticoids act so effectively in asthma and also why they are relatively ineffective in COPD, based on a better understanding of their molecular mechanisms.

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