Emerging concepts and directed therapeutics for the management of asthma: regulating the regulators

Madhur D. Shastri, Wai Chin Chong, Kamal Dua, Gregory M. Peterson, Rahul P. Patel, Malik Q. Mahmood, Murtaza Tambuwala, Dinesh K. Chellappan, Nicole G. Hansbro, Shakti D. Shukla, Philip M. Hansbro

Research output: Contribution to journalReview articlepeer-review

11 Citations (Scopus)
16 Downloads (Pure)

Abstract

Asthma is a common, heterogeneous and serious disease, its prevalence has steadily risen in most parts of the world, and the condition is often inadequately controlled in many patients. Hence, there is a major need for new therapeutic approaches. Mild-to-moderate asthma is considered a T-helper cell type-2-mediated inflammatory disorder that develops due to abnormal immune responses to otherwise innocuous allergens. Prolonged exposure to allergens and persistent inflammation results in myofibroblast infiltration and airway remodelling with mucus hypersecretion, airway smooth muscle hypertrophy, and excess collagen deposition. The airways become hyper-responsive to provocation resulting in the characteristic wheezing and obstructed airflow experienced by patients. Extensive research has progressed the understanding of the underlying mechanisms and the development of new treatments for the management of asthma. Here, we review the basis of the disease, covering new areas such as the role of vascularisation and microRNAs, as well as associated potential therapeutic interventions utilising reports from animal and human studies. We also cover novel drug delivery strategies that are being developed to enhance therapeutic efficacy and patient compliance. Potential avenues to explore to improve the future of asthma management are highlighted.
Original languageEnglish
Pages (from-to)15-33
Number of pages47
JournalInflammopharmacology
Volume29
Early online date5 Nov 2020
DOIs
Publication statusPublished online - 5 Nov 2020

Bibliographical note

Funding Information:
The authors acknowledge the support of fellowships from the University of Tasmania to MS, and the National health and Medical Research Council of Australia and Gladys Brawn/Faculty of Health and Medicine (1079187, 1175134), The University of Newcastle, UTS, and the Rainbow Foundation/Hunter Medical Research Institute to PMH.

Publisher Copyright:
© 2020, Springer Nature Switzerland AG.

Copyright:
Copyright 2020 Elsevier B.V., All rights reserved.

Keywords

  • Asthma
  • Molecular mechanisms
  • Novel drug candidates
  • Targeted drug delivery
  • Vascularisation
  • microRNA

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