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Asthma therapy: how far have we come, why did we fail and where should we go next?

¹ Firestone Institute for Respiratory Health, St. Joseph's Hospital, and ² Dept of Medicine, McMaster University, Hamilton, ON, Canada.

CORRESPONDENCE: L. J. Janssen, L-314, St. Joseph's Hospital, 50 Charlton Ave. East, Hamilton, ON, L8N 4A6 Canada. Fax: 905 5406510. E-mail: janssenl{at}mcmaster.ca

Keywords: Airway smooth muscle, asthma, ion channels, myosin light chain, receptors

Received: May 2, 2008
Accepted October 15, 2008

Reversible airflow obstruction and nonspecific airway hyperresponsiveness are: 1) the two key features of asthma; 2) the primary concern for asthma patients; and 3) both directly caused by the airway smooth muscle (ASM). As such, controlling bronchoconstriction should be of primary importance. Unfortunately, all existing pharmacological asthma therapies that specifically target the ASM are based on decades old strategies.

In the present study, the evolution of pharmacological asthma therapy will be briefly discussed, some explanations will be suggested as to why substantial new advances in this area have not occurred in several years and, finally, several new directions for novel asthma therapies will be proposed.