Daily Archive 18.01.2020

Prospects for the treatment of bronchial asthma

The possibilities of using adrenergic preparations of a-blocking and antihistamines of H-2-blocking are currently being studied. The use of potential bronchodilators, synthetic prostoglandins of the E1 prostaglandins series and E2 prostaglandins in the form of aerosols, is under study. However, they have a pronounced local irritant effect and can cause a paradoxical increase in airway resistance. It is believed that the systemic administration of prostaglandins in bronchial asthma is not very effective due to their rapid inactivation by PG dehydrogenase in the lungs and other tissues. Studies are being conducted in the direction of the synthesis and testing of drugs that block MPC-A (such substances may be lipoxygenase inhibitors that catalyze the synthesis of leukotrienes from arachidonic acid). It is assumed that these agents will significantly expand the therapeutic possibilities in bronchial asthma. In particular, the Hertrazan adrenaline synergist in vitro blocks the antigen-induced release of MPC-A highly efficiently. With an asthmatic triad, the possibility of desensitization to acetylsalicylic acid is studied, followed by treatment with non-steroidal anti-inflammatory drugs. The indications and possibilities of non-specific immunocorrective therapy are studied, and the effectiveness of various combination drugs (a combination of glucocorticosteroid drugs among themselves, as well as with bronchodilators) is evaluated.

New inhaled glucocorticosteroid preparations, derivatives of flunisolide (pulmicort, bronelide), have been created and are being tested. They have a pronounced anti-inflammatory activity, without causing systemic effects and fungal infections of the mucous membranes. Calcium antagonists attract attention. Good results were obtained with the use of nifedipine derivatives (Corinfar, Adalat), which may become the preferred means for combining bronchial asthma with coronary heart disease, arterial hypertension, but further studies are needed for final conclusions. Combined preparations of bronchodilators are studied, including theophylline, sympathomimetics and atropine-like substances.
Certain prospects are associated with the development of methods of extracorporeal detoxification (hemo-, plasmosorption, plasmapheresis) and specific immunosorption. The prospects of specific immunotherapy are associated with the effect on immunoregulatory cells and other ways.