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Editorial [Hot Topic:Anti-Inflammatory Strategy: Old Ally or New Promise in Therapy (Guest Editor: Marcella Reale)]

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The inflammatory response is a complex cascade of non-specific events resulting in excessive generation of inflammatory mediators such as cytokines, C-reactive protein and nitric oxide by cells of the innate (macrophages, monocytes, neutrophils) and adaptive (T-lymphocytes) arms of the immune system. Interactions of cells in the innate immune system, adaptive immune system, and inflammatory mediators orchestrate aspects of the acute and chronic inflammation that underlie diseases of many organs. Acute inflammation may lead to a systemic reaction known as the acute phase response in which stimulated macrophages secrete TNF-a, IL-1 and IL-6 which act on the hypothalamus to produce fever and on the liver to induce production of acute phase proteins. Inflammation participates importantly in host defences against infectious agents and injury, and it also contributes to the pathophysiology of many chronic diseases. The magnitude of the inflammatory response is crucial: insufficient responses result in immunodeficiency, which can lead to infection and cancer; excessive responses cause morbidity and mortality in diseases such as rheumatoid arthritis, Crohn's disease, atherosclerosis, diabetes, Alzheimer's disease, multiple sclerosis, and cerebral and myocardial ischemia. If inflammation spreads into the bloodstream, as occurs in septic shock syndrome, sepsis, meningitis and severe trauma, the inflammatory responses can be more dangerous than the original inciting stimulus.

Mastery of the inflammatory response should aid the development of novel strategies to predict disease susceptibility, target and monitor therapies, and ultimately develop new approaches to the prevention and treatment of chronic diseases. Homeostasis and health are restored when inflammation is limited by anti-inflammatory responses that are redundant, rapid, reversible, localized, and adaptive to changes in input and integrated by the nervous system.

There is still a high medical need for better therapy for many inflammatory diseases, such as eczema and psoriasis, rheumatoid arthritis, inflammatory bowel disease, multiple sclerosis and others. Many well established drugs on the market fail in patients with severe disease or have major side effects. Recently, significant progress has been made with the launch of some biologics such as cytokine neutralising antibodies (e.g. Anti-TNF alpha).

Here we focus our attention on the anti-inflammatory drugs and the diversity and complexity of the inflammatory and immulogical mechanisms in same disease, and have assembled a superb group of articles that deal with the broad issue of inflammatory and immunological disease mechanisms, processes that have relevance in psoriasis, scleroderma, polyposis, neurodegenerative disease and in other areas of pathology. Of necessity, these reviews deal with selected topics but the mixture of articles on specific antiinflammatory therapy with articles addressing different inflammatory diseases provides a broad overview of the field.
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Document Type: Research Article

Publication date: March 1, 2009

More about this publication?
  • Anti-Inflammatory & Anti-Allergy Agents in Medicinal Chemistry aims to cover all the latest and outstanding developments in medicinal chemistry and rational drug design for the discovery of new Anti-Inflammatory & Anti-Allergy Agents.

    Each issue contains a series of timely in-depth reviews written by leaders in the field covering a range of current topics in Anti-Inflammatory & Anti-Allergy Medicinal Chemistry.

    Anti-Inflammatory & Anti-Allergy Agents in Medicinal Chemistry is an essential journal for every medicinal chemist who wishes to be kept informed and up-to-date with the latest and most important developments in Anti-Inflammatory & Anti-Allergy Agents drug discovery.
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