Biotherapeutic Approaches to Asthma PDF

INTRODUCTION

Asthma is a very old disease. Medical writings dating from 2000 b.c. include descriptions of symptoms that today are recognizable as asthma. Thus, it is not surprising that these writings also describe many therapeutic approaches. What is surprising is what these approaches constituted then and in the many centuries that followed. For example, the Ebers Papyrus suggested that enemas would improve conditions resembling asthma! In other ancient cultures, plant extracts were used: Ma Huang, the source of ‘‘native’’ ephedrine, was used by the Chinese.

Over the centuries, asthma received considerable attention that led to the development and use of rather astonishing therapies, at least by current standards. Shell powder and spirits, opiates, and strong coffee were in favor at times. Perhaps most striking was the recommendation that a few puffs of tobacco smoke would alleviate asthma attacks.

Eventually anticholinergics, adrenergics, and theophylline became the treatments of choice. However, this armamentarium of new drugs did not significantly change the impact of asthma as a public health problem.

The latter part of the twentieth century saw an extraordinary revolution in medicine, in the understanding of the pathogenesis of disease, and in drug discovery. In the asthma field, the realization that this condition results from an inflammatory process completely modified the therapeutic approach. Anti-inflammatory agents, primarily glucocorticosteroids, coupled with powerful bronchodilators became standard therapy.

These advances did not slow the research, but rather intensified it. Some investigators dissected the inflammatory pathways, while others identified genetic determinations and DNA variants. The findings are leading to new therapeutic opportunities. And that is what this book is about! It explores and analyzes new therapeutic modalities that are emerging or, in some instances, are already being tested and even in use.

The editors, Dr. Jan Agosti and Dr. Albert Sheffer, have assembled a roster of contributors who are pioneers in their fields. Together, editors and authors represent the best of basic and clinical research—just what the patients need.

Often books give a panoramic view of the past and the present; this volume opens a window on the future and illustrates the benefits that asthma patients can expect.

The Lung Biology in Health and Disease series of monographs is privileged to have the opportunity to present this volume to its readership.