Inhaled Steroids in Asthma: Optimizing Effects in the Airways PDF

PREFACE

In the era that has witnessed the sequencing of the human genome, asthma remains a debilitating and sometimes fatal disease for those unfortunate enough to suffer from the inability to breathe inflicted by this condition. Now recognized as a disease that flourishes in association with the increases in standard of living in the twentieth century, asthma continues to defy all efforts of modern science and medicine to develop a cure. Although a number of exciting new strategies to treat the disorder have emerged over the last two decades, none has yet succeeded in managing the symptoms or diminishing the profound exacerbations of asthma as effectively as glucocorticoids. While we harbor great hope that new strategies for treating asthma will succeed, we must accept for the time being that glucocorticoids remain the most effective asthma medications and acknowledge that this may be true for decades to come.

Probably the biggest advances in inhaled glucocorticoid medications have resulted from efforts to improve targeting of these drugs to the lungs. This evolved from concerted and inspired scientific investigations in both industry and academia. It is extraordinarily important for the field of asthma—as well as for any other field of medicine that endeavors to utilize pulmonary drug delivery—that the accomplishments of the numerous individuals involved in these efforts be doc umented, chronicled, and evaluated. The intent of this volume is to gather the available information on inhaled glucocorticoid targeting in the lungs, based on the expertise and experience of leading asthma researchers and clinician–investigators. We hope that readers of this volume find it useful as a source of ideas, as a wellspring for future studies, and as an essential reference for the scientific literature on inhaled glucocorticoids.

The production of this volume would not have occurred without the important efforts of a number of individuals. We would like to express our gratitude to Dean Phizacklea of AstraZeneca for his generous support of this project. We also acknowledge the invaluable assistance of Mrs. Nicola Heller and Dr. Syed Shahabuddin, who were instrumental in documenting the discussion sessions of the volume. We also thank Christina Max for her help with the subject index. Our thanks also go to the staff of Marcel Dekker, Inc., and to Dr. Claude Lenfant, who provided the medium for this communication. Special thanks go to Ms. Bonnie Hebden for tackling the monumental task of assembling this volume with cheerfulness and great competence.

Finally, we are pleased to note that another important goal both of the meeting from which this volume evolved and of this book has been the desire of three of us (Robert P. Schleimer, Paul M. O'Byrne, and Stanley J. Szefler) to honor our beloved coeditor and colleague, Dr. Ralph Brattsand, and to recognize his inspired and outstanding contributions to the field of inhaled glucocorticoid treatment for asthma.