Academic journal article Environmental Health Perspectives

Expanding the Medicine Chest

Academic journal article Environmental Health Perspectives

Expanding the Medicine Chest

Article excerpt

About 10% of the asthmatic population has a severe form of the disease that can require progressively higher doses of corticosteroid drugs to manage the symptoms. Now a new therapeutic approach, described in the December 2005 issue of Thorax, may help people whose severe asthma symptoms no longer respond to steroid treatments.

Early research suggested that asthma was a so-called Th2 cytokine disorder involving certain white blood cells known as eosinophils. However, Stephen T. Holgate, a professor in the Infection, Inflammation, and Repair Division of Southampton General Hospital in the United Kingdom, and other researchers noticed that severe asthma was actually associated with neutrophils, another type of white blood cell that is associated with Th1 diseases such as rheumatoid arthritis and psoriasis. These diseases respond well to treatments that block the action of an immune system molecule called tumor necrosis factor-alpha (TNF-[alpha]). If severe asthma was truly a Th1 disease, Holgate hypothesized, it stood to reason that it too would respond to a TNF-[alpha] blocker.

To test this idea, Holgate and his colleagues administered the drug etanercept (Enbrel[R]) to 17 subjects with severe asthma in a 12-week study. Etanercept is a soluble receptor that binds to TNF-[alpha]. …

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