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Current Asthma Treatments - Get the Facts

Asthma is a common disease that is clinically characterized by various levels of chest tightness, cough, wheezing and breathlessness. Pathologically it is characterized by lymphocyctic and eosinophilic infiltration of the bronchial tree with associated airway narrowing. It is nothing but an inappropriate response of a previously sensitized airway to an allergen. The management of asthma depends on the severity of the condition as well as nature and frequency of attacks. Both pharmacological and non-pharmacological interventions are required in asthma control. Treatment should be started on a step higher than clinical indications and should be reduced once it is under control. Follow-up treatment is very important to determine the adequacy of current treatment.

Current asthma treatment emphasizes on symptomatic relief with short-acting bronchodilators and suppression of long-term inflammations with the use of corticosteroids. Also drugs such long-acting beta-2agonists, leukotriene agonists, cromones and theophylline are being used to control asthma in current treatment. Bronchodilators like Beta2 agonists and theophylline primarily provide symptomatic relief. They produce rapid onset of bronchodilation by directly stimulating the beta2 receptors in the smooth muscle of the airways. They also stabilize mast cells and protect against several stimuli of bronchoconstriction. Corticosteroids are the most effective treatment for asthma, revolutionized by inhaled therapy. They act by binding to an intracellular receptor and increase transcription of pro-inflammatory genes.

Inhaled corticosteroid therapy is the first line therapy for all but the mildest ones. The risk of hospitalization is reduced and readmission is also prevented more successfully in this therapy, besides reducing the need for rescue medication. Cromones are an alternative to low-dose inhaled steroids and improve symptom control in mild to moderate asthma as they seem to have an inhibitory effect on several inflammatory cells such as eosinophils, neutrophils and macrophages. Leukotriene agonists described as hybrid treatment because of their potential to relieve smooth muscle bronchoconstriction are effective in preventing inflammation and help improve lung condition, reduce use of rescue medication and exacerbation rates.