Review article
ASTHMA PHENOTYPES AND DISORDER OF THE IMMUNE SYSTEM HOMEOSTASIS
ASJA STIPIĆ MARKOVIĆ
; Department of Clinical Immunology, Pulmonology and Rheumatology, University Department of Medicine, Sveti Duh University Hospital, Zagreb, Croatia
Abstract
Many regulatory pathways involved in the pre- and post-IgE synthesis signaling have been elucidated and effects of numerous mediators included in allergic cascade understood; however, asthma remains a clinical and scientific problem. Immune system is being confused by modern civilization, producing complex interaction among epigenetic regulation, variable extrinsic factors and various combinations of paired effects, i.e. genes, antigens and life periods. It is therefore necessary to answer the question of how to ensure an adequate level of necessary immune stimuli at the time of intensive immune system development until age 6. Advances in immunology have enabled full asthma control but not cure in a great proportion of patients. Therefore, researchers have focused on particular features of specific inflammatory asthma subtypes, i.e. eosinophilic, neutrophilic, mixed and asthma without inflammatory cells. Therapeutic response to inhalant and systemic corticosteroids in a particular subtype is also investigated. The Global Initiative for Asthma Guidelines, developed by the group of experts and regularly updated with new scientific concepts, are available in clinical routine. The guidelines provide a useful framework for the choice of drugs and dosage, but they cannot replace clinician’s evaluation in individual approach to patient. However, current conditions still cannot ensure personalized asthma therapy.
Keywords
asthma; phenotypes; immune system homeostasis
Hrčak ID:
87889
URI
Publication date:
1.4.2011.
Visits: 1.369 *