INFLAMMATION IN ASTHMA - THE CORNERSTONE OF THE DISEASE AND TARGET OFTHERAPY

Asthma is a chronic disease associated with variable levels of airflow obstruction. Considerable evidence has been obtained to show that air way inflammation is a major factor in the pathogenesis of asthma in as sociated bronchial hyperresponsiveness, and in the level of disease se verity. The inflammatory pattern in asthma is multicellular in nature, with mast cells, neutrophils, eosinophils, T lymphocytes, and epithel ial cells participating in the response. Furthermore, it is known that mediators, cytokines, and chemokines from these cells contribute to t he orchestration of the inflammatory process. Because airway inflammat ion appears to be a critical etiologic feature of asthma, it has becom e the target of therapy In this review the features of airway inflamma tion will be examined, and the effect of therapeutic agents on markers of airway injury will be discussed. Establishing, understanding, and finally controlling the features of airway inflammation have given ins ight to disease pathogenesis and the effectiveness of various treatmen ts. The integral role of inhaled corticosteroids in modifying the comp lex inflammatory component of asthma will be explored, with special fo cus on the high degree of efficacy associated with this treatment-vis- a-vis other therapeutic agents-in preventing or blocking specific proi nflammatory markers.