Glucocorticoids (GCs) are the treatment of choice for chronic inflammatory diseases such as asthma. Despite proven effective anti-inflammatory and immunosuppressive effects, long-term and/or systemic use of GCs can potentially induce adverse effects. Strikingly, some recent experimental evidence suggests that GCs may even exacerbate some disease outcomes. In asthma, airway smooth muscle (ASM) cells are among the targets of GC therapy and have emerged as key contributors not only to bronchoconstriction, but also to airway inflammation and remodeling, as implied by experimental and clinical evidence. We here will review the beneficial effects of GCs on ASM cells, emphasizing the differential nature of GC effects on pro-inflammatory genes and on other features associated with asthma pathogenesis. We will also summarize evidence describing how GCs can potentially promote pro-inflammatory and remodeling features in asthma with a specific focus on ASM cells. Finally, some of the possible solutions to overcome these unanticipated effects of GCs will be discussed.

糖皮质激素 (GC) 是治疗哮喘等慢性炎症性疾病的首选药物。尽管已证明具有有效的抗炎和免疫抑制作用，但长期和/或全身使用 GC 可能会引起不良反应。引人注目的是，最近的一些实验证据表明，GCs 甚至可能加剧某些疾病的结果。在哮喘中，气道平滑肌 (ASM) 细胞是 GC 治疗的目标之一，并且已经成为不仅是支气管收缩的关键因素，而且是气道炎症和重塑的关键因素，正如实验和临床证据所暗示的那样。我们在这里将回顾 GC 对 ASM 细胞的有益影响，强调 GC 对促炎基因和其他与哮喘发病机制相关的特征的影响的不同性质。我们还将总结描述 GC 如何潜在地促进哮喘的促炎和重塑特征的证据，特别关注 ASM 细胞。最后，将讨论克服 GC 的这些意外影响的一些可能的解决方案。