Bronchial asthma is currently one of the most common human diseases. Epidemiological studies show that the incidence of asthma has reached 5% among the adult population, and 10% among children, representing a serious social, epidemiological and medical problem, attracting the ever-closer attention of healthcare professionals.

Use of corticosteroids for treating asthma

In the late 1940s, doctors began using systemic corticosteroids (a kind of oral steroids) to treat asthma, which played a significant role in the therapy of this disease. The mechanism of action of corticosteroids is provided by their ability to bind to specific glucocorticoid receptors in the cell’s cytoplasm. However, long-term use of systemic steroids pills leads to the appearance of undesirable systemic effects:

Oral steroids vs. inhaled steroids for treatment of bronchial asthma!

1) steroid diabetes and osteoporosis;

2) arterial hypertension;

3) drug ulcer of the stomach and intestines;

4) the frequent occurrence of an opportunistic infection (diseases caused by opportunistic viruses or cellular organisms that do not usually cause disease in healthy people);

5) myopathy. These negative effects of steroids limit the clinical use of the medicaments.

Anti-inflammatory effect of inhaled corticosteroids

In the late sixties, aerosols of water-soluble hydrocortisone and prednisolone were created. However, attempts to treat asthma with these drugs proved to be ineffective due to the fact that they had a low anti-asthmatic and high systemic effect, which could be compared with the effect of tableted corticosteroids. In the early 1970s, a group of liposoluble corticosteroids for local aerosol use was synthesized, which unlike water-soluble ones had high local anti-inflammatory activity, were characterized by low systemic action or lack of it in the therapeutic concentration. The clinical efficacy of this form of was demonstrated in a number of experimental studies.

Systemic action of corticosteroids

A long period of treatment with systemic corticosteroids (i.e. oral steroids), as a rule, suppresses the function of the hypothalamic-pituitary-adrenal axis. Inhaled corticosteroids have a moderate systemic effect due to the part of the drug that is absorbed in the bronchi, swallowed and absorbed in the intestine. This is related to the fact that inhaled corticosteroids have a short half-life and are rapidly biotransformed (chemically modified) in the liver after systemic absorption, which significantly reduces the time of their biological action.

Conclusion

Inhaled corticosteroids are among the most effective anti-inflammatory drugs for asthma. The main rule of corticosteroid therapy is the use of drugs in the minimum effective dose for the shortest possible time period necessary to achieve the maximum symptomatic effect.