FUTURE-DIRECTIONS IN ASTHMA THERAPY - IS A CURE POSSIBLE

Asthma correctly is characterized as a syndrome rather than a disease, because a single causative mechanism has not yet been defined, This l ack of definition makes the search for a cure extremely complex, Until a common pathogenetic link is identified, the possibility of a cure i s remote, The precise nature of the inflammatory response in asthma ha s not been defined, and current concepts of the pathogenesis of asthma represent, to some extent, a reductionistic approach to a process tha t has been seen variously as an allergic reaction, autonomic hyperresp onsiveness, or both. Additional evidence of the polygenomic nature of the disease and the inability to define a specific pathogenetic proces s linked to a final common pathway suggest that gene therapies probabl y will not be feasible, at least for the near future, As expected, mos t approaches nom being developed are directed toward improved therapie s, and optimal treatment may obviate the need to develop complex thera pies effecting a cure, Under any circumstance, the notion of a cure wi ll have to await a more comprehensive understanding of the syndrome kn own as human asthma, This article is intended to provide provocative i nsights into the reasons why a cure remains elusive.