How do inhaled corticosteroids like fluticasone act in the management of asthma?

Inhaled corticosteroids, such as fluticasone, primarily act by reducing airway inflammation, which is a key aspect of asthma management. Asthma is characterized by chronic inflammation of the airways, leading to symptoms such as wheezing, shortness of breath, and coughing. Fluticasone exerts its effects by modulating various inflammatory processes within the respiratory tract.

Upon inhalation, fluticasone enters airway epithelial cells and binds to glucocorticoid receptors. This interaction influences gene expression, resulting in the downregulation of pro-inflammatory cytokines, chemokines, and other mediators that contribute to the inflammatory response. By reducing inflammation, inhaled corticosteroids decrease the swelling and hyperreactivity of the airway tissues, leading to improved airflow and a reduction in asthma symptoms.

While some medications may directly stimulate bronchodilation or alter mucus secretion, corticosteroids are particularly effective at targeting inflammation, making them foundational in the long-term management of asthma. This anti-inflammatory effect is crucial for preventing asthma exacerbations and improving overall respiratory function.