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Tuesday, May 4, 2010

What is New in Asthma Treatment?

Posted by Prahallad Panda on 9:55 PM 3 comments

numbered version of :Image:Respiratory system ...Image via Wikipedia
There has been some addition of facts and precautions in treatment of asthma in the recent times. It will be appropriate to go straight to newer news on treatment of asthma.
Researchers say that vitamin D may actually be beneficial to the asthma patients. It has long been proved to be related to calcium metabolism and bone health. Now it has been learnt that Vitamin D regulates nearly 200 genes. Vitamin D deficiency has been shown to increase the risk of upper respiratory tract infections, tuberculosis; and decrease the forced expiratory volume in 1 second (FEV1) in asthma and wheezing diseases.
Vitamin D metabolism primarily takes place in the kidney and liver. Respiratory epithelial cells in addition to immune cells are also able to metabolize vitamin D and raising its local concentration to influence the associated genes. Its role in stabilizing the cells and keeping integrity of cells intact may be the mechanism of action in preventing the attacks of wheeze. It may also be helpful in preventing infection in the respiratory tract.
Airway remodeling and increase in smooth muscle cell number are associated with severe narrowing of respiratory tract in asthma. MMP-9, a disintegrin and a metalloproteinase-33’ (ADAM33) are the most relevant enzymes in airway remodeling. The levels of expression of these enzymes are associated with asthma development and severity. Researchers have seen that 1,25(OH)2D3 has a direct anti-proliferative effect on human airway smooth muscle cells and can inhibit the expression of both MMP-9 and ADAM33 suggesting a further beneficial role for vitamin D in the prevention and treatment of asthma.
Glucocorticoids are the most effective anti-inflammatory drugs in management of acute attack of asthma. Resistance to this therapy may also develop. It has been seen that Vitamin D enhances the action of steroids in resistant cases.
Recently it has been seen that long acting B2 stimulants may actually increase the cardiovascular events. FDA has cautioned its use in acute attack of asthma.More can be read here.
Also, recently USFDA has issued warning to the pharma companies to withdraw CFC (Chlorofluorocarbon) propelled inhalers like;
  • Nedocromil(Tilade Inhaler),
  • Metaproterenol (Alupent Inhalation Aerosol),
  • Triamcinolone (Azmacort Inhalation Aerosol),
  • Cromolyn (Intal Inhaler),
  • Flunisolide (Aerobid Inhaler System),
  • Albuterol and ipratropium combination (Combivent Inhalation Aerosol)
  • and
  • Pirbuterol (Maxair Autohaler).
This is in response to fulfill the obligation to help in protecting Ozone.
Hope in this “World Asthma Day”; the information will be helpful in planning the treatment of asthma patients.
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