Basic mechanisms of asthma. Role of inflammation.

It is now recognized that the basic reason for airway obstruction in asthma is chronic airway inflammation. The hyperresponsiveness and "bronchospasm" are, in part at least, a consequence of the inflammation. Optimum patient care needs to focus on preventing inflammation when possible and using anti-inflammatory drugs when prevention is not possible. When chronic asthma is mild, aerosol glucocorticoids or cromolyn suffice. Acute exacerbations that do not respond fully to bronchodilator drugs usually should be treated by a course of oral glucocorticoids. A few patients with severe disease require oral glucocorticoid therapy indefinitely.