Abstract
Asthma is a life-altering, chronic disease of heterogenous origin that features a complex interplay of immune and environmental signaling. Although very little progress has been made in prevention, diverse types of medications and delivery systems, including nanoscale systems, have been or are currently being developed to control airway inflammation and prevent exacerbations and fibrosis. These medications are delivered through mechanical methods, with various inhalers (with benefits and drawbacks) existing, and new types offering some variety in delivery. Of particular interest is the progress being made in nanosized materials for efficient penetration into the epithelial mucus layer and delivery into the deepest parts of the lungs. Liposomes, nanoparticles, and extracellular vesicles, both natural and synthetic, have been explored in animal models of asthma and have produced promising results. This review will summarize and synthesize the latest developments in both macro-(inhaler) and micro-sized delivery systems for the purpose of treating asthma patients.
Highlights
Asthma is a chronic disease featuring immune dysregulation as its core pathology.It affects hundreds of millions globally, evidenced by diagnosis rates that are climbing yearly, even as mortality decreases [1]
Beta adrenergic receptors found in the bronchial airway cause bronchoconstriction during an asthma attack, an effect countered by long-acting beta agonists (LABA) that promote bronchodilation in a synergistic action with Inhaled corticosteroids (ICS) (Table 1) [56,57]
Since modern medicine has failed at prevention, it currently focuses matic pathogenesis
Summary
Asthma is a chronic disease featuring immune dysregulation as its core pathology. It affects hundreds of millions globally, evidenced by diagnosis rates that are climbing yearly, even as mortality decreases [1]. With protective transforming growth factor-β (TGF-β) signaling mutatio having been reported, but, in general, avoidance of pet dander, plant pollens, dust, pm imperative to rapidly reduce inflammation within the airways as well as prevent errant acpollution, ozone, and cold air are required to minimize reactive airway hypersen tivation of the allergen hypersensitivity mechanism. Demographics affect the activity of the CYP gene family, as CYP1A2, CYP2A6, CYP2B6, CYP2C8, CYP2C9, and CYP3A4/5 are known to have higher activity in older adults, while allelic variations may correlate with increased susceptibility to cancers (breast, lung, prostate, etc.) or nicotine (CYP2A6*2 1799T > A) metabolism [31] As these important enzymes constitute the foundational processing for all substances entering the body, first-pass metabolism (in addition to age, gender, ethnic, and environmental variables) may limit the effectiveness of systemic oral medications for asthma control
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