CYTOKINE NETWORKS IN THE PATHOGENESIS OF BRONCHIAL-ASTHMA - IMPLICATIONS FOR THERAPY

Bronchial asthma is characterised by a multicellular inflammatory proc ess in the airways. The bronchial inflammation is orchestrated by a ne twork of cytokines and growth factors which includes those encoded by the GM-CSF/IL-4/IL-5 gene fluster on chromosome 5. Their cellular orig ins are diverse and include both inflammatory and structural cells in the airways, The efficacy of glucocorticoids in the therapy of bronchi al asthma may include the ability to disrupt these cytokine networks. The failure of glucocorticoids to provide benefit in some asthmatic pa tients may be caused by an excess of pro-inflammatory transcription fa ctors which Apl sequester the glucocorticoid receptor (GR), thereby pr eventing it from exerting its anti-inflammatory effects, Progress is b eing BAL made in the elucidation of the molecular regulation of the tr anscription of TH2 cytokine genes. These novel insights may provide fu ture strategies for therapeutic intervention in asthma.