RESUMEN

Los objetivos del tratamiento farmacológico del asma son el control de la sintomatología y la prevención de exacerbaciones, con efectos secundarios mínimos. Los fármacos utilizados pertenecen a dos categorías: terapia de mantenimiento y terapia de rescate. Los corticoesteroides inhalados o sistémicos bloquean la reacción de fase tardía de la respuesta inflamatoria alérgica y reducen la hiperreactividad de la vía aérea; también lográndose con la inmunoterapia específica de alergenos, consiguiendo tolerancia inmunológica al alergeno, y previniendo nuevas sensibilizaciones. En pacientes que no responden en forma adecuada al tratamiento según el grado de severidad, se pueden usar medicamentos inmunosupresores e inmunomoduladores como el metotrexate, indicado en pacientes seleccionados bajo la supervisión del especialista en asma, ya que conllevan importantes efectos adversos que pueden exceder el beneficio obtenido. Medicamentos del grupo de terapia biomolecular como el etanercept aún no cuentan con el sustento científico para su recomendación. El anticuerpo monoclonal anti-IgE (omalizumab) es recomendado en adultos y niños mayores de 12 años en quienes se ha comprobado la respuesta inflamatoria alérgica como factor causal del asma. En cuanto a las inmunizaciones en la infancia, sólo se refiere un posible efecto benéfico en las exacerbaciones con el uso de la vacuna antiinfluenza. Finalmente se abordan algunos puntos de interés en el tema de la farmacogenética.

PALABRAS CLAVE

Alergenos, asma, farmacogenética, inmunoterapia, inmunoterapia específica.

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