Inhaled corticosteroids: the role in the prevention of asthma, pathophysiological and clinical aspects

Abstract

Asthma is a complex disorder that displays heterogeneity and variability in its clinical expression both acutely and chronically. Asthma is a problem worldwide, with 300 million affected individuals. The prevalence of asthma varies from region to region but generally speaking it increases. Asthma is the most common chronicle disease in childhood. An understanding of the immune pathophysiology of airways in asthma has been markedly advanced with the use of bronchoscopy and biopsy. Corticosteroids are the most efficacious treatment for airway inflammation associated with asthma. Current guidelines recommend long-term treatment with inhaled corticosteroids (ICS) in the prevention of asthma. There is considerable variation in corticosteroid response among asthmatic subjects. Understanding the genetic mechanisms that regulate corticosteroid response variability could allow the determination of a subject’s response to corticosteroid therapy, leading to more effective dosing, selection of single-drug or combination therapies, or both for treating asthma.