Abstract
Topical and systemic glucocorticoids have long been considered the most effective therapy for chronic asthma. Asthma patients who do not respond to systemic administration of high-dose glucocorticoids are termed 'steroid-resistant asthmatics'. Recent progress in the mechanisms of glucocorticoid action goes a long way to the understanding of steroid resistance. Several cellular responses to glucocorticoids have been characterized in steroid-resistant asthma. Based on molecular biological studies, excessive expression of glucocorticoid receptor β and c-fos, an inducible transcription factor, was suggested to result in steroid resistance. A thorough understanding of the pathophysiology of steroid-resistant asthma would facilitate the development of more powerful agents for the treatment of severe asthma.
