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1. Introduction
2. Active smoking and asthma
3. Prevalence rates for active smoking in asthma
4. Poor asthma control in smokers
5. Chronic mucus hypersecretion in smokers
6. Health care utilization in smokers with asthma
7. Age-related decline in FEV1 in smokers
8. Persistent airflow obstruction, smoking & asthma
9. Reduced sensitivity to inhaled steroids
10. Impaired response to inhaled fluticasone
11. Impaired response to oral prednisolone
12. Corticosteroids sensitivity
13. Mechanisms of adverse effects
14. Non-eosinophilic inflammatory phenotype
15. Elevated induced sputum neutrophil count
16. Neutrophilic inflammatory phenotype
17. Increased bronchial biopsy mast numbers
18. Smokers with asthma-airway inflammation
19. Mechanisms for corticosteroid insensitivity
20. Molecular mechanisms of steroid resistance
21. Management of smoking asthmatics
22. Clinical benefits of smoking cessation
23. Stepwise management of chronic asthma (1)
24. Change in post-BD FEV1
25. Stepwise management of chronic asthma (2)
26. Impaired response to inhaled beclomethasone
27. Combination therapy: ICS + LABA
28. Leukotriene receptor antagonist
29. Tiotropium
30. Potential therapies for smokers with asthma
31. Restoration of corticosteroid sensitivity
32. Low dose theophylline & inhaled steroid
33. PPAR- gamma agonists
34. PPAR-gamma agonist - rosiglitazone
35. Change in FEV1 with rosiglitazone
36. Potential anti-inflammatory effects of statins
37. Exploratory clinical trial of atorvastatin
38. Atorvastatin in smokers with asthma (1)
39. Atorvastatin in smokers with asthma (2)
40. Conclusions: clinical
41. Conclusions: mechanisms
42. Conclusions: management
43. Acknowledgements
44. References (1)
45. References (2)
46. References (3)
47. References (4)

Topics Covered

• High prevalence rates of smoking in asthma
• Detrimental effects of smoking on clinical outcomes
• Impaired response to corticosteroids
• Mechanisms of adverse effects
• Management includes smoking cessation, but optimum drug therapy not established

Links

Series:

• Advances in Asthma

Categories:

• Clinical Practice
• Immunology

Therapeutic Areas:

• Immunology & Inflammation
• Respiratory Diseases

Talk Citation

Publication History

• Published on December 29, 2011

Financial Disclosures

• Prof. Neil Thomson, Grant/Research Support (Principal Investigator): Boston Scientific makes of the Alair system for bronchial thermoplasty: industry sponsored grant funding to the University of Glasgow for clinical trial work.