Mechanisms of bronchial inflammation in asthma: implications for therapy.

Chronic persistent infiltration of the airway submucosa by inflammatory cells such as eosinophils and lymphocytes is a hallmark of asthma, and may result in airway damage, bronchial obstruction and hyperresponsiveness. Genetic and environmental factors may predispose towards the development of this chronic submucosal airway inflammation. Priming of inflammatory cells by cytokines and growth factors, and release of mediators such as leukotrienes may be important mechanisms by which inflammation results in bronchial obstruction and hyperresponsiveness. The prime aim of asthma management is to prevent and dampen the inflammatory mechanisms, and corticosteroid therapy, which is most effective in the treatment of asthma, may act at several levels of the submucosal inflammatory process.