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Drug development for asthma.

Abstract

Asthma is characterized by abnormal immune cell accumulation and activation in the airways as well as dysfunction of specialized parenchymal cells. Research strategies to define asthma pathogenesis have focused on the hypothesis that this altered state is a consequence of an excessive allergen-driven response. Drug development for asthma has been directed at improving existing agents and expanding new modalities that target the Th2 allergic cascade. Significant opportunities are being pursued in each of these areas. However, this strategy may not account for some critical aspects of asthma pathogenesis. Alternative considerations include the need for a multidisciplinary approach to dissect the complexity of the asthma phenotype as well as a better understanding of nonallergic factors (especially viral reprogramming of airway behavior) in the development of the phenotype. Each of these considerations may provide an alternative strategy for further drug development for asthma and other complex diseases.

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BibTeXRIS

Michael J Holtzman. 2003. Drug development for asthma.. https://doi.org/10.1165/rcmb.f276

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A randomized comparison of dexamethasone 0.15 mg/kg versus 0.6 mg/kg for the treatment of moderate to severe croup.

BACKGROUND: Although previous studies have shown that dexamethasone is useful in croup, the optimal dosage has not been clarified yet. The aim of this study was to investigate the effectiveness of dexamethasone 0.15 mg/kg single dose compared with the recommended dose of 0.6 mg/kg for treatment of hospitalized children with moderate to severe croup. METHOD: Forty-one children aged 6 months to 5 years admitted from March 2001 to October 2003 at the pediatric ward of Hatyai Hospital with moderate to severe croup were recruited for the study. After random allocation, each child received a single intravenous injection of either dexamethasone 0.6 mg/kg (maximum dose 12 mg) or 0.15 mg/kg (maximum dose 3 mg). All children were given a single dose of epinephrine nebulization at the beginning of the study. The croup scores were measured at 0, 1, 2, 3, 4, 6, 8, 10 and 12 h after the dexamethasone injection. RESULTS: One hour following the injection, the mean croup scores were significantly reduced from baseline values in both groups (p<0.01). There was no difference in the mean croup scores between the two groups at any time. Median times to croup scores equal or less than two in both high- and low-dose groups were 8 and 7.9 h, respectively. No patient required intubation or was removed from the study because of a rising croup score after enrollment. There was no significant adverse reaction from dexamethasone treatment in either group. CONCLUSION: Dexamethasone 0.15 and 0.6 mg/kg are equally effective in the treatment of moderate to severe croup.

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