Editorial [Guest Editor: Strategies for the Improvement of Asthma Therapy (Executive Editor: Andreas Pahl)]

E-ISSN： 1873-4286|12|25|3173-3174

ISSN： 1381-6128

Source： Current Pharmaceutical Design, Vol.12, Iss.25, 2006-09, pp. : 3173-3174

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Abstract

Asthma bronchiale, affecting 155 millions people worldwide, has emerged as a major public health problem worldwide over the past 20 years. Although data indicate that current asthma therapies led to limited decreases in death rates, it continues to be a significant health care problem. As we head into the 21st century doctors have a vast arsenal of drugs and treatments at their disposal allowing asthmatics to lead normal fulfilled lives. Can we improve asthma therapy available at present? Indeed, despite a large number of drugs available to clinicians, up to 15% of patients suffer from uncontrollable disease symptoms, increasing the demand for novel therapies that possess new modes of action. Despite considerable efforts by the pharmaceutical industry, it has been difficult to develop novel therapeutic agents; the leukotrien modifiers are the only new class of asthma treatments that has been approved. Fortunately, omelizumab (an anti-IgE) has very recently been introduced and appears to be effective and an addition to the currently available therapeutics. In addition, there are numerous therapies in clinical development that combat the inflammation found in asthma.This issue of “Current Pharmaceutical Design” contains the text of nine invited review articles. The selection of topics and authors was made with the intention to cover various areas of ongoing drug development efforts for asthma therapy.Asthma is not a natural disease in the animal kingdom. Debates come up from time to time whether mice can develop asthma or not. Therefore the variety of artificially established animal models is quite wide. Animal experimentation has been indispensable not only in establishing or verifying the safety and the effectiveness of a given drug candidate but animal models have been crucial in providing basic information about the physiological and pathological processes associated with the disease. Kurucz and Szelenyi [1] review the current state of the art of animal models used to investigate asthma. They analyse how these different models contributed to our understanding of the disease and how successfully they helped to recognize or to introduce new, more effective pharmacons that can be used for the treatment of asthma.Great variability in patient responses to current asthma therapy is observed in the clinic. Whereas, for example, a lot of patients respond well to steroid treatment, some patients are resistant to this kind of therapy. The review by Pahl et al. [2] deals with various aspects of genetic and genomic variability as one source for this observed variability.For many years phosphodiesterases (PDEs) attracted little attention in drug discovery efforts. However, the success of viagra and new generation PDE5 inhibitors reinforced interest in targeting other PDEs for chronic airway diseases. Meanwhile, PDE4 inhibitors such as roflumilast are close to market approval. Giembycz and Smith [3] review the literature of another phosphodiesterase isoenzyme (PDE7A) as a new drug candidate for asthma therapy.Folkerts and Nijkamp [4] will mainly deal with the possible therapeutic application of the NO concept. Such interventions might be targeted in various ways, e.g. by using selective reactive nitrogen- and oxygen-scavengers, selective NO donors and selective nitric oxide synthase inhibitors. The possible therapeutical opportunities are reviewed in this paper. Nitric oxide has already made it from the bench to the bedside, and it is likely that new developments in this area will drastically change respiratory medicine during the coming 5-10 years.Airway remodelling is one of the hallmarks of asthma pathogenesis. The article by Das et al. [5] will focus on this aspect. Since the pathological changes are thought to contribute to the clinical symptoms of the disease new targets may arise from these changes. It may be feasible to have therapeutics with disease modifying effects in chronic inflammatory diseases. Therefore, this raises the po