[Physiopathology of inflammatory events in asthma]

Inflammatory events in asthma include an initiation step dependent on dendritic cells, an effector step which involves the release of a large number of mediators by inflammatory cells, mastocytes, polymorphonuclear neutrophils and eosinophils, alveolar macrophages and monocytes, and lymphocytes; and a repair phase leading to airway remodeling. In addition to classic mediators such as histamine and leucotrienes, it is currently accepted that cytokines and chimokines play an essential role in local cellular trafficking. The bronchial endothelium and epithelium are simultaneously activated. Bronchial inflammation is constant in patients with allergic asthma and persists even in the absence of symptoms. Links between the intensity of the inflammatory response and the occurrence of airway remodeling suggest that therapeutic interventions should take place as early as possible, particularly in children.