Beclomethasone dipropionate: a new steroid aerosol for the treatment of allergic asthma
01 Jan 2017-pp 335-342
TL;DR: Beclomethasone dipropionate was used in pressurized aerosols for the treatment of 60 cases of chronic allergic asthma for up to 15 months, and no biochemical evidence of adrenal suppression was found.
About: The article was published on 2017-01-01 and is currently open access. It has received 301 citations till now.
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TL;DR: This approach is already suggesting entirely novel pathways to disease-eg, alternative macrophage specification, steroid refractory innate immunity, the interleukin-17-regulatory T-cell axis, epidermal growth factor receptor co-amplification, and Th2-mimicking but non-T-cell,interleukins 18 and 33 dependent processes that can offer unexpected therapeutic opportunities for specific patient endotypes.
887 citations
University of Oxford1, Wellington Management Company2, University of Barcelona3, University of Melbourne4, University of Amsterdam5, Ghent University Hospital6, Erasmus University Rotterdam7, National Institutes of Health8, Imperial College London9, Université de Montréal10, University of California, San Francisco11, Boston Children's Hospital12, John Hunter Hospital13, University of Newcastle14, Queen's University Belfast15, University of Western Australia16, French Institute of Health and Medical Research17, Université Paris-Saclay18, University of New South Wales19, University of Arizona20, Ludwig Maximilian University of Munich21, University of Pittsburgh22, University of Cape Town23
TL;DR: The only way to make progress in the future is to be much more clear about the meaning of the labels used for asthma and to acknowledge the assumptions associated with them, which are believed to be the most important causes of the stagnation in key clinical outcomes observed in the past 10 years.
712 citations
TL;DR: In patients with COPD and severe asthma and in asthmatic patients who smoke HDAC2 is markedly reduced in activity and expression as a result of oxidative/nitrative stress so that inflammation becomes resistant to the anti‐inflammatory actions of corticosteroids, and theophylline, by activating HDAC, may reverse this cortiosteroid resistance.
Abstract: Corticosteroids are the most effective anti-inflammatory therapy for many chronic inflammatory diseases, such as asthma but are relatively ineffective in other diseases such as chronic obstructive pulmonary disease (COPD). Chronic inflammation is characterised by the increased expression of multiple inflammatory genes that are regulated by proinflammatory transcription factors, such as nuclear factor-kappaB and activator protein-1, that bind to and activate coactivator molecules, which then acetylate core histones to switch on gene transcription. Corticosteroids suppress the multiple inflammatory genes that are activated in chronic inflammatory diseases, such as asthma, mainly by reversing histone acetylation of activated inflammatory genes through binding of liganded glucocorticoid receptors (GR) to coactivators and recruitment of histone deacetylase-2 (HDAC2) to the activated transcription complex. At higher concentrations of corticosteroids GR homodimers also interact with DNA recognition sites to active transcription of anti-inflammatory genes and to inhibit transcription of several genes linked to corticosteroid side effects. In patients with COPD and severe asthma and in asthmatic patients who smoke HDAC2 is markedly reduced in activity and expression as a result of oxidative/nitrative stress so that inflammation becomes resistant to the anti-inflammatory actions of corticosteroids. Theophylline, by activating HDAC, may reverse this corticosteroid resistance. This research may lead to the development of novel anti-inflammatory approaches to manage severe inflammatory diseases.
700 citations
Cites background from "Beclomethasone dipropionate: a new ..."
...The breakthrough that revolutionised asthma therapy was the introduction of inhaled corticosteroids that had topical activity in 1972 (Brown et al., 1972)....
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TL;DR: The association linking corticosteroid therapy with the development of posterior subcapsular cataracts has been well documented, and significant progress has been made in elucidating the mechanism by which corticoids bring about theDevelopment of these opacities.
298 citations
References
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TL;DR: The December 1950 issue was the last of the eightieth volume of the American Journal of Diseases of Children, a periodical devoted to pediatrics that first appeared in 1911.
Abstract: THE DECEMBER 1950 issue was the last of the eightieth volume of theAmerican Journal of Diseases of Children. The first volume appeared in 1911. When the Board of Trustees of the American Medical Association met on Feb. 4, 1910, Dr. Isaac Abt and Dr. F. S. Churchill, on behalf of a number of pediatricians, presented the following communication requesting the publication by the Association of a periodical devoted to pediatrics: Appreciating the need in America of a journal of pediatrics published and entirely controlled by the medical profession; impressed, morever, by the high character and success of the Archives of Internal Medicine established by your Board two years ago, we respectfully request that you establish a journal of pediatrics on somewhat similar lines. There is at present no journal in the English language devoted to this important branch of medicine, which at all corresponds, for example, to the Jahrbuch
82 citations