Bronchial asthma — a new paradigm in GINA clinical recommendations. Рart 2

A systematic review of the literature provides an analysis of changes in the standards of basic treatment according to the new GINA recommendations, taking into account the mechanisms of pharmacological action of glucocorticosteroids (GCS), which are the main means of controlling the course of bronchial asthma (BA).Objective — analysis of prospects for establishing control over bronchial asthma, taking into account the new clinical recommendations of GINA for the appointment of anti-inflammatory therapy based on the analysis of key aspects of the pharmacological action of glucocorticoids in a pandemic COVID-19.Materials and methods. Access to various full-text and abstract databases was used.Results and discussion. According to the IPCRG, patients are not always able to differentiate between the symptoms of an asthma attack and COVID-19 infection. This leads to untimely care for these diseases, and discontinuation of inhaled corticosteroids (ICS) can have serious consequences. ICS directly or indirectly by acting at the genetic level increase the amount and functional activity of anti-inflammatory proteins, b2-adrenoceptors and inhibit the synthesis of pro-inflammatory cytokines, enzymes and activation of inflammatory receptors. An important feature of ICS is their ability to reduce the survival of important inflammatory cells such as eosinophils, through the mechanism of blocking the effects of interleukin-5 and granulocyte-macrophage colony-stimulating factor with the start of the process of controlled apoptosis in these cells.Conclusions. GINA emphasizes the poor adherence to the algorithm of the proposed strategy of anti-inflammatory therapy and not esthisas a modifying risk factor for exacerbations in COVID-19. Significant for the control of inflammation in asthma actions of corticosteroid sare mediated at the molecular level through genomic dextra genomic mechanisms.