Role of inhaled steroids in vascular airway remodelling in asthma and copd

Family history is a risk factor for asthma, with many different genes being implicated. [67] If one identical twin is affected, the probability of the other having the disease is approximately 25%. [67] By the end of 2005, 25 genes had been associated with asthma in six or more separate populations, including GSTM1 , IL10 , CTLA-4 , SPINK5 , LTC4S , IL4R and ADAM33 , among others. [68] Many of these genes are related to the immune system or modulating inflammation. Even among this list of genes supported by highly replicated studies, results have not been consistent among all populations tested. [68] In 2006 over 100 genes were associated with asthma in one genetic association study alone; [68] more continue to be found. [69]

Genetics play a role in the development of COPD. [9] It is more common among relatives of those with COPD who smoke than unrelated smokers. [9] Currently, the only clearly inherited risk factor is alpha 1-antitrypsin deficiency (AAT). [46] This risk is particularly high if someone deficient in alpha 1-antitrypsin also smokes. [46] It is responsible for about 1–5% of cases [46] [47] and the condition is present in about three to four in 10,000 people. [16] Other genetic factors are being investigated, [46] of which many are likely. [11]

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  • Citation tools Download this article to citation manager Bush Andrew , Grigg Jonathan , Saglani Sejal . Managing wheeze in preschool children BMJ 2014; 348 :g15
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    Guidance on prescribing topical steroids reminds practitioners to prescribe the least strong steroid which is effective for the least possible length of time. A balance must be struck between efficacy and reducing adverse effects. Education is crucial to maximise efficacy and reduce adverse effects. Use of printed information may be helpful (including detail of how to use emollients and topical steroids) and education involving practice nurses to help improve efficacy of treatments and information for patients. Examples can be obtained from the British Association of Dermatologists and the National Eczema Society.

    Role of inhaled steroids in vascular airway remodelling in asthma and copd

    role of inhaled steroids in vascular airway remodelling in asthma and copd

    Guidance on prescribing topical steroids reminds practitioners to prescribe the least strong steroid which is effective for the least possible length of time. A balance must be struck between efficacy and reducing adverse effects. Education is crucial to maximise efficacy and reduce adverse effects. Use of printed information may be helpful (including detail of how to use emollients and topical steroids) and education involving practice nurses to help improve efficacy of treatments and information for patients. Examples can be obtained from the British Association of Dermatologists and the National Eczema Society.

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