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Asthma
A E Tattersfield
a * , A J Knox
a , J R Britton a
and I P Hall b
Abstract
Asthma is one of the commonest chronic diseases of affluent societies.
The striking increase in prevalence of asthma over recent decades and
the rarity of this disease in less affluent populations confirms the
importance of environmental factors in the cause of asthma—although
which environmental factors are responsible is still not clear. Family
studies show that genetic factors are also important in determining
individual susceptibility to asthma, with results of genetic studies
suggesting that there are many genes with moderate effects rather than a
few major genes. Asthmatic airways show inflammation and remodelling,
with CD4+ helper cells, mast cells, and eosinophils characterising the
inflammatory response. Inhaled corticosteroids remain the cornerstone of
treatment with the addition of long-acting β agonists
as the next step if symptoms continue. Leukotriene antagonists, the only
new drugs to reach the market in the past decade, have modest effects.
However, a better understanding of the mechanisms underlying asthma and
the genetic and environmental factors that predispose individuals to
asthma should lead to better preventative strategies and new therapeutic
approaches.
Affiliations:
a Division
of Respiratory Medicine, Clinical Sciences Building, City Hospital,
Nottingham, UK.
b Division of Therapeutics, University Hospital, Queen's
Medical Centre, Nottingham, UK.
Copyright
© 2002 Elsevier Science Ltd All rights reserved.
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