Abstract

One of the challenges to the management of severe asthma is the poor therapeutic response to treatment with glucocorticosteroids. Compounds derived from marine sources have received increasing interest in recent years due to their prominent biologically active properties for biomedical applications, as well as their sustainability and safety for drug development. Based on the pathobiological features associated with glucocorticoid resistance in severe asthma, many studies have already described many glucocorticoid resistance mechanisms as potential therapeutic targets. On the other hand, in the last decade, many studies described the potentially anti-inflammatory effects of marine-derived biologically active compounds. Analyzing the underlying anti-inflammatory mechanisms of action for these marine-derived biologically active compounds, we observed some of the targeted pathogenic molecular mechanisms similar to those described in glucocorticoid (GC) resistant asthma. This article gathers the marine-derived compounds targeting pathogenic molecular mechanism involved in GC resistant asthma and provides a basis for the development of effective marine-derived drugs.

Highlights

  • Asthma is a chronic inflammatory disease of the lower airways characterized by airway hyperresponsiveness and remodeling, leading to wheeze, cough, chest tightness, and difficulty in breathing

  • According to the current guidelines [5], difficult-to-control asthma is asthma that is uncontrolled despite treatment with high-dose inhaled glucocorticoids (ICS) combined with long-acting β2 -agonists or other controllers, or that requires such treatment to maintain good symptom control and reduce exacerbation; severe asthma is considered a subset of difficult-to-control asthma that is uncontrolled despite adherence to maximal optimized Step 4 or Step 5 therapy and treatment of contributory factors, or that worsens when high-dose treatment is reduced

  • Many marine-derived biologically active compounds target pathogenic molecular mechanisms common to those described in GC-resistant asthma; we sought in this review to gather the marine-derived compounds targeting the pathogenic molecular mechanism involved in GC resistant asthma and to provide a basis for the development of effective marine-derived drugs

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Summary

Introduction

Asthma is a chronic inflammatory disease of the lower airways characterized by airway hyperresponsiveness and remodeling, leading to wheeze, cough, chest tightness, and difficulty in breathing. A common feature of patients with severe asthma is their poor response to high doses of ICS and systemic glucocorticoids (GCs). This inadequate response is called steroid-unresponsive or GC resistance. These patients, may respond well to β2-adrenergic agonist-mediated vasodilation; but if after 2 weeks of appropriate-dose steroid treatment the improvements in forced expiratory volume in 1 s (FEV1) are

Pathobiological Features Associated with Glucocorticoid Resistance
Mechanisms of Action of Glucocorticoids
Glucocorticoids Resistance
Cellular
Th2 Cytokines
Findings
Conclusions

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