Is asthma an inflammatory disease?

In the 1950s, asthma was defined in terms of reversible airflow obstruction; and then during the 1980s, the emphasis on the diagnosis and treatment of asthma centered on airway hyperreactivity. Recent advances in molecular biology and immunopathology have focused diagnosis and treatment of asthma on inflammatory mechanisms. This article briefly reviews some of the inflammatory components of asthma and the rationale for using inhaled (topical) anti-inflammatory agents in treatment. It also calls attention to some potential and actual adverse effects of inhaled corticosteroids. It mentions some agents used as alternate therapy for "steroid resistant" patients. The alteration of airway immunopathology of asthmatics before and after use of inhaled corticosteroids is described. There is evidence that treatment directed solely towards airway inflammation without use of inhaled B-agonist agents does not eliminate airway hyperresponsiveness.