What is the mechanism of action of inhaled corticosteroids used for asthma maintenance?

Inhaled corticosteroids play a crucial role in the maintenance therapy of asthma by primarily inhibiting cytokines and reducing inflammation throughout the airways. These medications, such as fluticasone and budesonide, work at a cellular level by promoting the transcription of anti-inflammatory proteins and inhibiting the expression of pro-inflammatory cytokines, chemokines, and various inflammatory mediators.

This anti-inflammatory effect helps to decrease airway hyperresponsiveness, thus improving overall lung function and reducing the frequency of asthma exacerbations. The effectiveness of inhaled corticosteroids in managing asthma highlights the significance of controlling inflammation rather than solely focusing on bronchodilation or symptom relief.

While bronchodilation, stimulation of beta-2 receptors, and reduction of mucus production are also important aspects of asthma management, these actions are primarily associated with other classes of medications, such as bronchodilators (e.g., beta-agonists) or mucolytics, rather than the action of inhaled corticosteroids themselves. Thus, the focus on the role of inhaled corticosteroids in inhibiting cytokines and inflammation underscores their importance in the long-term control of asthma symptoms.