Asthma treatment and asthma prevention: A tale of 2 parallel pathways

Research output: Contribution to journalArticle

29 Scopus citations

Abstract

Three recent clinical trials used different study designs to test the hypothesis that early introduction of inhaled corticosteroids in infants and young children at high risk for the development of asthma could change the natural course of the disease. All 3 trials reached the same conclusion: treatment requirement, symptom frequency while off treatment, and lung function did not differ between children receiving active drug or placebo, with outcomes measured 2 to 4 years after randomization. These findings challenge the concept that the inflammatory processes that cause asthma symptoms and are responsive to inhaled corticosteroids are also responsible for the chronic changes in airway structure and function that are believed to predispose to the development of persistent asthma. This conclusion is supported by studies showing that bronchial hyperresponsiveness, independent of current asthma symptoms, is associated with subsequent deficits in airway function growth during childhood. Successful strategies for the prevention of asthma will require a better understanding of the genetic, environmental, and developmental factors that predispose toward inappropriate responses to airway injury. Abnormal airway remodeling and persistent dysregulation of airway tone might be the final common pathway for different disease mechanisms, and this might explain the heterogeneity of clinical phenotypic syndromes that go under the common label of "asthma.".

Original languageEnglish (US)
Pages (from-to)30-33
Number of pages4
JournalJournal of Allergy and Clinical Immunology
Volume119
Issue number1
DOIs
StatePublished - Jan 1 2007

Keywords

  • Asthma
  • bronchial
  • hyperresponsiveness
  • inhaled corticosteroids
  • lung function
  • remodeling

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology

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