INFLAMMATION, INFLAMMATORY MEDIATORS, AND MEDIATOR ANTAGONISTS IN ASTHMA

Asthma is an inflammatory disease that involves mast cells, antigen-pr esenting cells, eosinophils, neutrophils, and TH2-lymphocytes. These c ells produce a broad array of mediators and cytokines that lead to the bronchoconstriction, mucosal edema, mucus secretion, and bronchial hy perresponsiveness that characterize asthma. Current guidelines for the rapy recommend that all patients whose asthma is more severe than mild intermittent receive chronic treatment with drugs that interrupt this inflammatory cascade. Corticosteroids have been the gold standard for treatment, but a greater understanding of the specific cells and medi ators involved in the pathogenesis of asthma has led to more focused, specific therapy. Pharmacologic agents that interrupt the synthesis of action of leukotrienes, and monoclonal antibodies directed against in tracellular adhesion molecules or immunoglobulin E are examples of the new generation of specific targeted therapy for use in asthma. Journa l of Clinical Pharmacology, 1998;38:577-582 (C)1998 The American Colle ge of Clinical Pharmacology.