Recent advance of medications brings more effective treatment intervention to the patients with asthma. As far as referring guidelines, approximately 90% of patients with asthma can acquire good control. However, some of them resist conventional treatment. Most of them have corticosteroid-resistant airway inflammation. There are two ways to deal with this problem. The first one is biologics. Biologics are introduced for some patients with difficult asthma and outstanding results are also seen. The second one is a treatment focusing on cancellation of corticosteroid-resistance. In early 2010s, a new-intracellular signaling pathway (phosphatydilinositol-3-kinese pathway: PI3K pathway) is proven to be closely associated with corticosteroid-resistance (CR). PI3K-inhibitor should be promising to attenuate CR. But PI3K-inhibitor also has a toxicity when it is given systemically. To deal with this problem, drug-repositioning (DR) is a good option. To find out PI3K-inhibitor from numerous existing medicines enables us to inhibit PI3K pathway safely and effectively. The presenter has found both low-dose theophylline1) and long-acting beta-2 agonist2) have a potential to antagonize PI3K. These medicines have been prescribed for long time and their safety has already been proved. DR obtains cheap and safe options to treat specific intracellular signaling pathways. The presenter will reveal that the fundamentals of this strategy and show how to adjust it to real patients with difficult asthma in this talk.
1) To Y et al. Am J Respir Crit Care Med 2010
2)Rossios C et al. Br J Pharmacol 2012