From:  Ensuring patient safety: a closer look at glucocorticoid therapy in COPD and asthma

 A summary of key corticosteroid-sensitive and corticosteroid-resistant pathways in COPD.

ICS-resistance inflammatory pathwaysICS-sensitive inflammatory pathways
  • Neutrophil and/or eosinophil numbers

  • Macrophage-IL-8-neutrophil axis

  • IL-33-ILC2-IL-5 axis, leading to eosinophil recruitment

  • Macrophage TNF-α and IL-6 release

  • Lymphocyte numbers

  • Mast cells

  • Type 2 airway inflammation

TNF-α: tumor necrosis factor α; ICS: inhaled corticosteroids; COPD: chronic obstructive pulmonary disease.