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1. Introduction
2. Overview
3. Asthma pathophysiology
4. Clinical phenotypes of asthma
5. Anti-IL5 asthma studies
6. Anti-IL13 study
7. Anti-TNFalpha in patients with refractory asthma
8. Anti-TNF-alpha therapies
9. Spectrum of steroid responsiveness
10. Costs of severe asthma
11. How steroids work in the airways
12. Classical mechanism of glucocorticoid action
13. Dexamethasone induction of MKP-1
14. Molecular actions of glucocorticoids
15. Dissociation of corticosteroid effects
16. GR immunolocalisation in sputum cells
17. Effect of FP and salmeterol on GR translocation
18. Combination therapy
19. Relative steroid insensitivity
20. Skin blanching response to topical budesonide
21. Dex fails to suppress selected gene expression
22. Effect of dexamethasone on GM-CSF production
23. GR beta association with steroid resistance
24. MAPKs affect steroid responsiveness
25. IL-2/IL-4 affect GR Kd: role of p38 MAPK
26. IL-2/IL-4 induces dex-insensitivity in PBMCs
27. IL-2/IL-4 modulate GR translocation ability
28. Enhanced p38 MAPK activity
29. New safer MAPK inhibitors with a topical steroid
30. JNK activation is not repressed by prednisolone
31. Steroid insensitivity induction by TCR
32. Infection and steroid responsiveness
33. Increased bacterial LPS expression
34. Superantigen-induced GR insensitivity
35. RV-induced steroid resistance in asthma
36. TH-17 associated cytokines
37. IL-17 attenuates steroids effects in mice
38. Loss of anti-inflammatory mediators
39. IL-10
40. Vitamin D enhances IL-10 production
41. Vitamin D therapy and IL-10 expression
42. Smoking reduces steroid function in asthma
43. Smoking and steroid response in asthma
44. Altered glutathione homeostasis in children
45. Oxidative stress prevents GR translocation
46. Oxidative stress induces steroid insensitivity
47. Inhibitory effect of dex and HDAC activity
48. Cigarette smoke reduces HDAC activity
49. HAT and HDAC activity in asthmatic biopsies
50. Reduced HDAC and increased HAT activity
51. Theophylline enhances dexamethasone function
52. Randomisation strategy - smoking asthma
53. Smoking asthma - lung function (PEF)
54. Summary
55. Heterogeneity of 'causes' of CS insensitivity
56. Relationship between drivers of steroid resistance
57. Conclusion
58. Acknowledgements

Topics Covered

• Overview of asthma pathophysiology
• Patterns of severe refractory asthma
• Methods to improve steroid efficacy in severe asthma
• Mechanisms that induce steroid insensitivity; Th2 cytokines, IL-17 and infections
• Pathophysiology of severe treatment refractory asthma
• Novel anti-inflammatory approaches
• Can new combinations of drugs reverse steroid insensitivity in severe asthma?

Links

Series:

• Advances in Asthma

Categories:

• Clinical Practice
• Immunology
• Pharmaceutical Sciences

Therapeutic Areas:

• Immunology & Inflammation
• Respiratory Diseases

Talk Citation

Adcock, I. (2011, December 29). Steroid resistance in asthma: mechanisms and potential therapies [Video file]. In The Biomedical & Life Sciences Collection, Henry Stewart Talks. Retrieved April 15, 2025, from https://doi.org/10.69645/EHHY3796.
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Publication History

• Published on December 29, 2011
• Archived on January 31, 2022

Financial Disclosures

• Prof. Ian Adcock has not informed HSTalks of any commercial/financial relationship that it is appropriate to disclose.