Role of bronchoscopy in asthma research

Fiberoptic bronchoscopy and associated techniques of airway sampling have c ontributed immensely to our understanding of asthma pathogenesis. The major advance of investigative bronchoscopy has been the ability to obtain infor mation that is not readily available by other monitoring methods in asthmat ics. The current paradigm of asthma, a chronic inflammatory airway disorder , has been strongly supported and advanced by the study of mild asthmatics by investigative bronchoscopy. Bronchoalveolar lavage, airway mucosal brush ing, endobronchial biopsy, and measurement of airway gases have been perfor med in mild asthmatics to further characterize the nature of inflammation w ith experimental challenge procedures as well as with various anti-inflamma tory therapies. This article reviews the following issues: general guidelin es from several workshops and the relative safety of bronchoscopy in asthma research; technical issues related to specimen retrieval and processing; a nd data obtained from studies that have used bronchoscopy for investigation of stable asthma, asthma with allergen provocation, or asthma treated with anti-inflammatory therapy.