Therapy of asthma in adults: the control of bronchial inflammation

Inflammatory events involve the airways in asthma. Bronchial inflammation can induce and maintain both variable airflow obstruction and bronchial hyperresponsiveness. The rationale of asthma therapy is, therefore, to use drugs which prevent and reduce the inflammation. The control of asthmatic inflammation needs specific management. Interestingly, if corticosteroids are effective, non-steroidal anti-inflammatory drugs have a negligible effect. On the other hand, sodium cromoglycate and ketotifen can act on bronchial inflammation. Moreover, in well-selected patients, immunotherapy and a strict environmental prophylaxis can play a key role in long-term therapy. In asthmatics, a careful control of inflammation can protect airways from irreversible bronchial obstruction and return bronchial hyperresponsiveness to within the range of clinical well-being.