Zusammenfassung
Asthma ist eine chronisc he Entzündungserkrankung, die durch eine variable Atemwegsobstrukt ion und einer bronchialen Hyperreaktivität charakterisiert ist.
Die inflammatorische Aktivität spielt eine wesentliche Rolle bei der Evolution des Asthma bronchiale und ist in der Regel auf eine antiintflammatorische Therapie wie Kortison empfindlich.
Ein Großteil der Patienten spricht auf diese Medikation sehr gut an, jedoch ist eine Abnahme der Kortisonwirkung bei langjähriger Therapie moglich, wie es auch Hinweise gibt, daß eine fehlende Ansprechbarkeit auf Gluk okortikoide angeboren sein kann.
Es gibt mehrere Mechanismen, die eine Kortisonresistenz bewirken können. Die Diagnose einer fehlenden Empfindlichkeit von Kortison ist insofern von großer Bedeutung, da durch die Darstellung der molekularen Mechanismen dieses Phänomens ein besseres Verständnis der Kortisonwirkung und der Pathophysiologie des Asthmas erlangt werden kann.
Eine fehlende Ansprechbarkeit auf Kortison kann sowohl klinisch, als auch anhand von Laboruntersuchun gen diagnostiziert werden. Der folgende Review beschreibt die molekularbiologischen Aktivitaten einer Kortisonresistenz beim Asthma bronchiale und wie Kortikoide eine chronische Inflammation supprimieren können.
Summary
Asthma is a chronic respiratory disease characterized by reversible airflow limitation and airway responsiveness to a variety of stimuli.
Airway inflammation is thought to play a significant role in the above process.
These components of asthma are all responsive to corticosteroids which inhibit airway inflammation and immune response, and seems to attenuate airway responsiveness.
Most patients respond favourably to conventional therapy, however, resistance to the antiinflammatory presents a management problem.
There may be several mechanisms for resistance to the effects of glucocorticoids, and it is important to characterize patients with steroid resistance carefully which may provide new insights into the mechanisms of steroid action as well as the underlying chronic disease process.
Corticoid responsiveness can be assessed clinically and also in terms of cellular responsiveness with regard to both local and circulating inflammatory cells.
This review will present concepts of the molecular basis of glucocorticoid resistance in asthma and how glucocorticoids suppress chronic inflammation.
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Pohl, R.W. (2000). Definition und pathophysiologische Grundlagen der Steroidresistenz. In: Kummer, F., Kneußl, M. (eds) Das therapieresistente Asthma. Springer, Vienna. https://doi.org/10.1007/978-3-7091-6335-1_1
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DOI: https://doi.org/10.1007/978-3-7091-6335-1_1
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