1. New perspectives in bronchial asthma: pathological, immunological alterations, biological targets, and pharmacotherapy.
- Author
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Mandlik DS and Mandlik SK
- Subjects
- Animals, Anti-Asthmatic Agents adverse effects, Anti-Inflammatory Agents adverse effects, Asthma immunology, Asthma metabolism, Asthma physiopathology, Bronchodilator Agents adverse effects, Disease Models, Animal, Humans, Lung immunology, Lung metabolism, Lung physiopathology, Molecular Targeted Therapy, Phenotype, Risk Factors, Signal Transduction, Anti-Asthmatic Agents therapeutic use, Anti-Inflammatory Agents therapeutic use, Asthma drug therapy, Bronchoconstriction drug effects, Bronchodilator Agents therapeutic use, Lung drug effects
- Abstract
Asthma is the most common, long-lasting inflammatory airway disease that affects more than 10% of the world population. It is characterized by bronchial narrowing, airway hyperresponsiveness, vasodilatation, airway edema, and stimulation of sensory nerve endings that lead to recurring events of breathlessness, wheezing, chest tightness, and coughing. It is the main reason for global morbidity and occurs as a result of the weakening of the immune system in response to exposure to allergens or environmental exposure. In asthma condition, it results in the activation of numerous inflammatory cells like the mast and dendritic cells along with the accumulation of activated eosinophils and lymphocytes at the inflammation site. The structural cells such as airway epithelial cells and smooth muscle cells release inflammatory mediators that promote the bronchial inflammation. Long-lasting bronchial inflammation can cause pathological alterations, viz. the improved thickness of the bronchial epithelium and friability of airway epithelial cells, epithelium fibrosis, hyperplasia, and hypertrophy of airway smooth muscle, angiogenesis, and mucus gland hyperplasia. The stimulation of bronchial epithelial cell would result in the release of inflammatory cytokines and chemokines that attract inflammatory cells into bronchial airways and plays an important role in asthma. Asthma patients who do not respond to marketed antiasthmatic drugs needed novel biological medications to regulate the asthmatic situation. The present review enumerates various types of asthma, etiological factors, and in vivo animal models for the induction of asthma. The underlying pathological, immunological mechanism of action, the role of inflammatory mediators, the effect of inflammation on the bronchial airways, newer treatment approaches, and novel biological targets of asthma have been discussed in this review.
- Published
- 2020
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