Arm, Jonathan P. Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, Boston, Massachusetts.
Sheffer, Albert L. Brigham and Women's Hospital, Boston, Massachusetts.
Last reviewed:April 2019
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- Identifying triggers
- Goals of asthma therapy
- Pharmacological therapy
- Preventive therapy
- Inhaled corticosteroids
- Leukotriene-modifying drugs
- Long-acting beta-2 agonists
- Other lines of therapy
- Treatment of asthma attacks
- Links to Primary Literature
- Additional Readings
An allergic inflammatory disease of the pulmonary airways, marked by labored breathing, wheezing, and coughing. Asthma is a serious pulmonary disease that inflames and narrows the airways of the lungs (Fig. 1). The inflammation involves mast cells, eosinophils, macrophages, fibroblasts, and neutrophils, and the inflammatory changes are associated with widespread airflow obstruction, which is variable and improves (reverses) spontaneously or with appropriate therapy. The inflammation progresses to increased airway irritability (hyperresponsiveness) and episodes of airflow obstruction induced by the inhalation of allergens, cold air, and occupational factors. Although a bronchospasm can be induced immediately after exposure to a specific allergen in an appropriately sensitized recipient, it is the late allergic response that most resembles the inflammatory reaction occurring in asthma. Central to this reaction is the release from mast cells, eosinophils, and lymphocytes of chemical mediators such as histamine, leukotrienes (potent bronchoconstricting agents), prostaglandins, and various cytokines that perpetuate the response. Potent neurohumoral agents derived from neural pathways contribute further to the bronchospasm. See also: Allergy; Cytokine; Eicosanoids; Inflammation; Lung; Mast cells; Respiratory system; Respiratory system disorders
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