Asma e DPOC: está na hora de mudar conceitos e o foco do tratamento
Asthma and COPD: it is time to change concepts and treatment targets
Hisbello S. Campos; Celso E. Ungier
Resumo
A asma e a doença pulmonar obstrutiva crônica (DPOC) compõem um grupo de doenças respiratórias obstrutivas crônicas nas quais as disfunções refletem múltiplos processos inflamatórios do trato respiratório. Os mecanismos patogenéticos envolvidos em ambas são influenciados por uma interação entre redes genéticas contendo genes alterados (polimorfismos), estímulos ambientais, biológicos ou físicos, e a população de microrganismos que habita nosso corpo (microbioma). Aparentemente, parte dos polimorfismos genéticos envolvidos são comuns a ambas, justificando algumas semelhanças observadas entre elas. Atualmente, os esquemas medicamentosos usados no tratamento de ambas são compostos, basicamente, por broncodilatadores e corticosteroides inalatórios. Estas classes farmacológicas são efetivas apenas sobre parte dos processos patogênicos envolvidos, o que pode justificar as taxas inadequadas de sucesso terapêutico. O progresso na compreensão dos fatores envolvidos na gênese das alterações no comportamento celular do trato respiratório vem apontando novos alvos terapêuticos, o que vem impulsionando estudos visando o desenvolvimento de fármacos potencialmente mais efetivos.
Palavras-chave
Abstract
Asthma and chronic obstructive pulmonary disease (COPD) comprise a group of chronic obstructive respiratory diseases in which the dysfunctions reflect multiple inflammatory processes of the respiratory tract. The pathogenetic mechanisms involved in the two conditions are influenced by an interaction between genetic networks containing altered genes (polymorphisms), environmental, biological or physical stimuli, and the population of microorganisms that inhabit our body (microbiome). Apparently, part of the genetic polymorphisms involved are common to both asthma and COPD, justifying some similarities between the conditions. Currently, the drug regimens used in the treatment of the two diseases are basically composed of inhaled bronchodilators and corticosteroids. These pharmacological classes are effective against only a part of the pathogenic processes involved, which may justify the inappropriate rates of therapeutic success. An improved understanding of the factors involved in the genesis of altered cell behavior in the respiratory tract has been pointing to new therapeutic targets, driving studies aimed at the development of potentially more effective drugs.
Keywords
Referências
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Submetido em:
23/02/2018
Aceito em:
26/02/2018
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