Genes and Pathways Regulating Decline in Lung Function and Airway Remodeling in Asthma

Hur, Gyu Young; Broide, David H.

Corticosteroids are currently the most effective anti-inflammatory therapy in asthma as they reduce asthma symptoms and the frequency of rescue β 2 -adrenergic agonist inhaler use as well as prevent asthma exacerbations and deaths from asthma. Corticosteroids are also effective in improving pulmonary function and in reducing AHR. Several studies using bronchial biopsies have also demonstrated that corticosteroids reduce airway inflammation in asthma. However, the ability of corticosteroids to reduce airway remodeling is not well established. There are numerous studies that support as well as refute the role for corticosteroids in reducing airway remodeling. [77] [78] [79] [80] Although the majority of studies demonstrate that corticosteroids reduce the features of airway remodeling in asthma, 79, 80 several studies do not support a role of corticosteroids in reducing airway remodeling. 77, 78 The differences in the results may be due to differences in the dose, duration, and compliance with corticosteroid therapy, as well as the site of biopsy (most studies have proximal and not small airways in biopsy), severity of asthma and remodeling end points studied (most studies do not have smooth muscle in biopsy).