Inhaled glucocorticosteroids in treatment of bronchial asthma

: Studies of bronchial asthma pathogenesis, conducted over many years, have shown that inflammatory process plays a major role in the development of this disease. Glucocorticosteroids are agents with strongest antiinflammatory activity and together with beta 2-agonists are thought of as firstline therapy in the treatment of bronchial asthma. New inhaled glucocorticosteroids are preparations with small systemic activity, despite the fact, that some of them are more lipophyllic than the others, despite the differences in solubility, affinity to lung tissue, different serum concentrations and affinity to receptors. Even with the tremendous progress in increasing efficacy and lowering side effects of inhaled glucocorticosteroids, no ideal preparation was found so far, however the antiinflammatory activity was increased and the dose lowered, which means increasing clinical efficacy and lowering the systemic effects. Only in the future we can hope for developing an ideal preparation of inhaled glucocorticosteroid with common specificity towards lung tissue and direct influence on the target cell, and maybe even on a specific gene.