Page 27 - Škrgat, Sabina, ed. 2022. Severe Asthma - Basic and Clinical Views. Koper: University of Primorska Press. Severe Asthma Forum, 1
P. 27
Story of Corticosteroids in Asthma 2.1
Stylianos Vittorakis1, Chrysa Kontogianni2, Anastasia Levounets2,
Eleftherios Zervas2 and Mina Gaga2
Abstract 1 Private Practice, Chania,
Asthma is a common respiratory disease affecting patients of all ages and races. Up to the mid- Greece
dle of the 20th century there was scarce knowledge regarding the biology of the disease and
asthma was a potentially lethal disease with very limited therapeutic options. The introduction 2 7th Respiratory Medicine
of corticosteroids revolutionized the management of asthma and improved the lives of millions Department and Asthma
of patients. Parental and later oral administration was the first treatment with remarkable ef- Center, Athens Chest Hospital
fects on asthma symptoms and exacerbations but led to serious systemic effects. The invention “SOTIRIA”, Athens, Greece
of inhaled forms of corticosteroids that had minimal systemic absorption and adverse reac-
tions, the enhancement of their efficacy by LABAs and the understanding of asthma patho-
physiology were only a few of the significant advances in asthma management over the last 60
years. In this review we present these life-changing advances in asthma treatment, focusing οn
the evolutionary role of corticosteroids.
Keywords: asthma history, asthma treatment, OCS, ICS, LABA
Introduction: Historical Overview writings of Hippocrates, however, the term
probably refers to asthma as a symptom and
Asthma is a chronic inflammatory airway dis- not to the disease we know today. Ιn the begin-
ease affecting patients of all ages and races. ning of the 19th century, asthma was defined
It is characterized by heterogeneity which is as an airway disease characterized by bron-
defined by different underlying disease pro- chospasm following invention of the stetho-
cesses and pathophysiological characteristics scope by Laennec (1781-1826).3 The first re-
(phenotypes).1 This heterogeneity is reflect- ports of asthma as an extrinsic or intrinsic
ed in therapeutic interventions that have been disorder caused by stress or animal dander
extensively evaluated during the last 20 years are attributed to Henry Hyde Salter in 1860.
or so. In his treatise “On Asthma: its Pathology and
Treatment”, Salter describes asthma as a dis-
The term asthma is a Greek noun, άσθμα, ease in which the airways narrow as a re-
which derives from the verb ασθμαίνω mean- sult of contraction of their smooth muscle.4
ing to exhale with open mouth, to pant. The A few years later Paul Ehrlich (1854-1915)
first written record of asthma appears around described eosinophils and mast cells in asth-
2700 years ago in Homer’s Iliad. The earli- matic sputum using eosin and toluidine blue
est text where the word asthma is found as a staining.5 Sir William Osler (1849-1919),
medical term is in the writings of the school
of Hippocrates of Kos (460-360 B.C.).2 In the
https://doi.org/10.26 493/978 -961-293 -157-5.27-36
Stylianos Vittorakis1, Chrysa Kontogianni2, Anastasia Levounets2,
Eleftherios Zervas2 and Mina Gaga2
Abstract 1 Private Practice, Chania,
Asthma is a common respiratory disease affecting patients of all ages and races. Up to the mid- Greece
dle of the 20th century there was scarce knowledge regarding the biology of the disease and
asthma was a potentially lethal disease with very limited therapeutic options. The introduction 2 7th Respiratory Medicine
of corticosteroids revolutionized the management of asthma and improved the lives of millions Department and Asthma
of patients. Parental and later oral administration was the first treatment with remarkable ef- Center, Athens Chest Hospital
fects on asthma symptoms and exacerbations but led to serious systemic effects. The invention “SOTIRIA”, Athens, Greece
of inhaled forms of corticosteroids that had minimal systemic absorption and adverse reac-
tions, the enhancement of their efficacy by LABAs and the understanding of asthma patho-
physiology were only a few of the significant advances in asthma management over the last 60
years. In this review we present these life-changing advances in asthma treatment, focusing οn
the evolutionary role of corticosteroids.
Keywords: asthma history, asthma treatment, OCS, ICS, LABA
Introduction: Historical Overview writings of Hippocrates, however, the term
probably refers to asthma as a symptom and
Asthma is a chronic inflammatory airway dis- not to the disease we know today. Ιn the begin-
ease affecting patients of all ages and races. ning of the 19th century, asthma was defined
It is characterized by heterogeneity which is as an airway disease characterized by bron-
defined by different underlying disease pro- chospasm following invention of the stetho-
cesses and pathophysiological characteristics scope by Laennec (1781-1826).3 The first re-
(phenotypes).1 This heterogeneity is reflect- ports of asthma as an extrinsic or intrinsic
ed in therapeutic interventions that have been disorder caused by stress or animal dander
extensively evaluated during the last 20 years are attributed to Henry Hyde Salter in 1860.
or so. In his treatise “On Asthma: its Pathology and
Treatment”, Salter describes asthma as a dis-
The term asthma is a Greek noun, άσθμα, ease in which the airways narrow as a re-
which derives from the verb ασθμαίνω mean- sult of contraction of their smooth muscle.4
ing to exhale with open mouth, to pant. The A few years later Paul Ehrlich (1854-1915)
first written record of asthma appears around described eosinophils and mast cells in asth-
2700 years ago in Homer’s Iliad. The earli- matic sputum using eosin and toluidine blue
est text where the word asthma is found as a staining.5 Sir William Osler (1849-1919),
medical term is in the writings of the school
of Hippocrates of Kos (460-360 B.C.).2 In the
https://doi.org/10.26 493/978 -961-293 -157-5.27-36
