Therapies to control the airway inflammation of asthma

The natural history of the development of airway inflammation in asthma is reviewed together with the known histopathological changes, measurable effects and symptoms. The factors thought to cause the airway inflammation and the associated hyperresponsiveness of the airways are summarized and the stages at which interventions are likely to be effective are indicated. The complications of severe asthma, including early death, are discussed and the aims of therapy are described in relation to these aims. The drugs available to control asthma are briefly reviewed and a practical summary of patient management is given. The potential advantages of this form of treatment, which can be described as 'tight control', are summarized and likely future developments, with emphasis on preventing the disease, are outlined.