Aimed at specialists in respiratory medicine, this new book comprehensively reviews the variety of agents currently available for treatment of asthma, COPD, and other airway diseases and covers practical guidelines as well as challenges and complications in their use. Advances in Combination Therapy for Asthmaand COPD is the first book to address the complexity of multi-agent therapy and deal with management issues in an integrated fashion. A review of currentlyavailable agents and their applications, as well as new therapies soon to become available are outlined. Advantages of combined therapies and additional considerations that arise from multi-agent programs are highlighted. INDICE: Contributors xiPreface xiii1 Similarities and differences in the pathophysiology of asthma and COPD 1J. Christian Virchow1.1 Introduction 11.2 Pulmonary function abnormalities in asthma and COPD 31.3 Risk factors for asthma and COPD 51.4 Cellular inflammation in asthma and COPD 81.5 Distribution andconsequences of inflammation in asthma and COPD 91.6 Patterns of epithelial injury in asthma and COPD 101.7 Airway hyperresponsiveness 101.8 Beta-receptor blockers 101.9 Differential diagnosis of asthma and COPD 111.10 Overlap syndrome 121.11 Conclusion 12References 132 Glucocorticoids: pharmacology and mechanisms 16Peter J. Barnes2.1 Introduction 162.2 Chemical structures 162.3 The molecular basis of inflammation 172.4 Cellular effects of glucocorticoids 192.5 Glucocorticoid receptors 202.6 Glucocorticoid activation of gene transcription 222.7 Suppression of inflammatory genes 232.8 Steroid resistance 292.9 Interaction with 2-adrenergic receptors 322.10 Conclusions 33References 333 Inhaled corticosteroids: clinical effects in asthma and COPD 38Paul M. O’Byrne and Desmond M. Murphy3.1 Introduction 383.2 Anti-inflammatory activity of corticosteroids 383.3 Routes of administration 393.4 Absorption and fate of corticosteroids 413.5 Currently available inhaled corticosteroids 413.6 Efficacy in asthma 433.7 Efficacy in COPD 443.8 Side effects of ICS 463.9 Conclusions 49References494 LABAs: pharmacology, mechanisms and interaction with anti-inflammatory treatments 53Gary P. Anderson4.1 Galenical forms of LABAs: formulations, isomers, enantiomers, diasteriomers and salts 554.2 Absolute and functional 2-adrenoceptor selectivity 564.3 Cellular organization of receptor clusters: functionalstructure of the 2-adrenoceptor and mode of signalling 584.4 Dimers and oligomers: homo- and heterodimerism/oligoism 604.5 Pharmacogenomics of the 2-adrenoceptor and adenylate cyclase polymorphism in relation to LABAs 614.6 Understanding the reassertion’ paradox, exosites’ and relative speed of onset: the membrane diffusion microkinetic model of LABA action 614.7 Regulation and desensitization 634.8 Full versus partial agonism (pharmacological efficacy) 644.9 Beta-blockers not LABAs? 674.10 Non-receptor-mediated effects? 684.11 Biochemicalbasis of functional antagonism and its critical role in LABA action in disease and exacerbations 684.12 Molecular cooperativity between LABAs and steroids 694.13 Perspective 73References 735 Long- and ultra-long-acting 2-agonists 81Mario Cazzola and Maria Gabriella Matera5.1 Introduction 815.2 Long-acting 2-agonists 825.3 Novel ultra-long-acting 2-agonists 865.4 Conclusion 95References 956 The safety of long-acting beta-agonists and the development of combinationtherapies for asthma and COPD 102Victor E. Ortega and Eugene R. Bleecker6.1 Introduction 1026.2 Asthma-related mortality and beta-agonist exposure 1036.3 Long-acting beta-agonists and increased asthma-related mortality 1056.4 Safety and efficacy of LABA therapy in asthma: retrospective analyses 1076.5 Efficacyof LABA therapy as a component of combination therapy with ICS for the management of asthma 1106.6 Scientific basis of the beneficial and adverse effects of beta-agonist therapy: in vitro data and the beta-agonist paradox 1136.7 Conclusions regarding the safety of LABA therapy as a component of combination therapy with ICS for the management of asthma 1146.8 Beta-agonist therapy and adverse events in COPD 1156.9 Safety and efficacy of LABA therapy in the management of COPD: the clinical evidence 1166.10 Role of LABA therapy as a component of combination therapy with ICS for the management of COPD 1176.11 Conclusionsregarding the safety of LABA therapy as a component of combination therapy for the management of COPD 1206.12 Pharmacogenetics of LABAs and combination therapy 1206.13 Safety and efficacy of LABA therapy and the development of combination therapies for the management of asthma and COPD 1266.14 Summary and future directions 127Acknowledgement 128References 1287 Inhaled combination therapy with glucocorticoids and long-acting 2-agonists in asthma and COPD, current and future perspectives 135Jan L tvall7.1 Pharmacological management guidelines of asthma and COPD 1357.2 Steroid treatment in asthma 1367.3 Effects of adding LABA to inhaled glucocorticoids in asthma 1377.4 Steroid treatment in COPD 1407.5 Effects of LABAs in COPD 1407.6 Combination inhalers versus two separate inhalers for inhaled GCS and LABAs 1417.7 Regular treatment alone versus additional formoterol-containing combinations as reliever therapy 1437.8 Currently available combination inhalers 1457.9 Upcoming and alternative combinations of inhaled GCS and LABAs 1467.10 Future of combined inhalation therapy in respiratory disease 148References 1498 Novel anti-inflammatory treatments for asthma and COPD 154Paul A. Kirkham, Gaetano Caramori, K. Fan Chung and Ian M. Adcock8.1 Introduction 1548.2 Current asthma and COPD therapies 1588.3 The need for new therapies 1608.4 Improving current therapies 1628.5 Targeting chemokinesand their receptors in asthma and COPD 1668.6 Targeting T-cell-derived and proinflammatory cytokines in asthma and COPD 1698.7 Targeting adhesion moleculesin asthma and COPD 1728.8 Growth factor blockers in asthma and COPD 1738.9 Mucous cells, submucosal glands and mucus production in asthma and COPD 1738.10 Infections in asthma and COPD 1748.11 Intracellular signalling pathways 1758.12 Inhibition of transcription factors in asthma and COPD 1788.13 Antioxidants in asthma and COPD 1818.14 Immunomodulation and anti-allergy treatments in asthma and COPD 1828.15 Conclusions 185Acknowledgements 186References 1869 Novel biologicals alone and in combination in asthma and allergy 203Sharmilee M. Nyenhuis and William W. Busse9.1 Introduction 2039.2 Targets of therapy 2049.3 Interleukin-4 2049.4 Interleukin-5 2079.5 Interleukin-13 2119.6 Tumor necrosis factor-2129.7 Immunoglobulin E 2159.8 DNA vaccines 2209.9 Future directions 2229.10 Conclusion 224References 22510 Anti-infective treatments in asthma and COPD 232Jonathan D.R. Macintyre and Sebastian L. Johnston10.1 Introduction 23210.2 Current guidelines 23410.3 Acute exacerbations of asthma 23610.4 Increased susceptibility to infection in asthmatics 23610.5 Role of atypical bacteria inasthma 23710.6 Role of viruses in asthma exacerbations 24410.7 Anti-infectives in COPD exacerbations 25010.8 Use of antibiotics in stable COPD 25610.9 Roleof vaccination 25710.10 Conclusion 259References 26011 Long-acting muscarinicantagonists in asthma and COPD 268M. Diane Lougheed, Josuel Ora and Denis E. O’Donnell11.1 Introduction 26811.2 Innervation of the airways 26811.3 Cholinergic mechanisms in asthma and COPD 27011.4 Role of long-acting anticholinergic bronchodilators in obstructive lung disease 27111.5 Summary 287References 28812 Phosphodiesterase inhibitors in obstructive lung disease 296Jan L tvall and Bo LundbÃñ ck12.1 Introduction 29612.2 Phosphodiesterase enzymes 29712.3 Different pharmacological agents blocking PDE4 29812.4 Biological effects of PDE4 inhibition, preclinical information 30012.5 Clinical effects of PDE4 inhibitionin COPD 30212.6 Effects of PDE4 inhibitors on systemic processes in COPD 30412.7 Side effects of PDE4 inhibitors 30412.8 PDE4 inhibitors in COPD managementplans 30512.9 Future prospects with PDE4 inhibitors in obstructive airways disease 30512.10 Summary 306References 30613 Biological therapies in developmentfor COPD 311J. Morjaria and R. Polosa13.1 Introduction 31113.2 Inflammatory cells involved in the pathogenesis of COPD 31213.3 Cytokines and chemokines in COPD 31513.4 Development of biological agents in COPD 32013.5 Conclusions 323References 32314 Triple therapy’ in the management of COPD: inhaled steroid, long-acting anticholinergic and long-acting 2-agonist 333Ronald Dahl14.1 Introduction 33314.2 Long-acting inhaled anticholinergic (LAMA) and 2-agonist (LABA) bronchodilators 33314.3 Treatment strategies for COPD 33414.4 Inhaled corticosteroids and COPD 33414.5 Combination treatment with ICS, LAMA and LABA: tripletherapy’ 33514.6 Extracted data from TORCH and UPLIFT studies 33714.7 Conclusions 340References 341Index 343
- ISBN: 978-1-119-99862-4
- Editorial: John Wiley & Sons
- Encuadernacion: Rústica
- Páginas: 364
- Fecha Publicación: 29/02/2012
- Nº Volúmenes: 1
- Idioma: Inglés