Asthma as an Inflammatory Disease

Abstract

Asthma has been described primarily as an inflammatory process only in the last 5 to 10 years. Previously, it was thought of primarily as a disease of nerves and smooth muscle. This inflammatory process is now considered to be an immunologically initiated, mediator-driven event. The observation that asthma is associated with an inflammatory process in the lungs has dramatically changed our understanding of the pathophysiology and treatment of this disease. Like many other theories that have undergone a significant change in direction, it is possible that over the next few years the pendulum will begin to swing back. The nerves and smooth muscles may (or may not) be implicated directly again. It is conceivable that in addition to an inflammatory process, underlying alterations in the architecture of the lungs will also be found. These alterations might serve to amplify the effects of inflammation, thereby leading to the clinical manifestations of asthma.