Asthma is one of the atopic diseases strongly associated with allergy. High
aeroallergen exposure in the immediate postnatal period has been associate
d with higher risk of sensitization and chronic asthma. It is proposed that
Following in utero allergen sensitization, postnatal high dose allergen ex
posure localizes inflammation to the airways. In association with adjuvanti
zing effects of some virus infections, eosinophils and neutrophils are recr
uited which contribute to epithelial damage and the initiation of the remod
elling process. Eventually, the latter processes lead to sufficient airway
narrowing to manifest as the first symptoms of asthma. Thus, the immunopath
ology of asthma is fully established by the time of first symptoms and futu
re strategies will need to identify those at risk of developing the disease
before irreversible changes in the airways are established.