Rai IBN. J Respir Indones. 2009;29(4).
We often find outpatient asthma patient smoking. Actively smoking asthma patient showed more severe symptom and more frequent attack than non smoking group of patient. Cigarette smoking induced neutrophilic inflammation in asthma patients airway. Beside that, decreased sensitivity to inhaled or oral corticosteroid treatment also plays very important role in asthma patient who actively smoke. In biomolecular point of view, this steroid insensitivity mainly caused by decreasing in histone deacetylase (HDAC) activity. Cigarette smoking may produced oxidant and cause diminished in the HDAC activity in asthma patient who smoke. Decreased in HDAC activity then prevent corticosteroid to halt inflammatory genes transcription. Several studies found anti inflammation effect of low dose theophylline to deal with this situation. Molecular mechanism and anti inflammatory property of theophylline for this function remains unclear. But several evidence suggest low dose theophylline effective in addition to corticosteroid treatment in asthma patients who currently smoking. Several studies also found low dose theophylline activate HDAC nuclear enzyme and stopped multiple activated inflammatory genes. While corticosteroid play important role in recruitment HDAC to inflammatory genes transcription site. This synergistic action give promising advance in the field of anti inflammation treatment in the future.
Keywords : Asthma, Smoking, Histone deacetylase (HDAC), Low dose teophylline, asma, merokok, perokok asma, asma perokok, teofilin dosis rendah, dosis teofilin