Abstract
Ultimately, asthma is a disease characterized by constriction of airway
smooth muscle ( ASM). The earliest approach to the treatment of asthma
comprised the use of xanthines and anti- cholinergics with the later
introduction of anti- histamines and anti- leukotrienes. Agents directed
at ion channels on the smooth muscle membrane ( Ca2+ channel blockers,
K+ channel openers) have been tried and found to be ineffective.
Functional antagonists, which modulate intracellular signalling pathways
within the smooth muscle ( beta- agonists and phosphodiesterase
inhibitors), have been used for decades with success, but are not
universally effective and patients continue to suffer with exacerbations
of asthma using these drugs. During the past several decades, research
energies have been directed into developing therapies to treat airway
inflammation, but there have been no substantial advances in asthma
therapies targeting the ASM. In this manuscript, excitation-contraction
coupling in ASM is addressed, highlighting the current treatment of
asthma while proposing several new directions that may prove helpful in
the management of this disease.
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