Asthma: the new advances.
There has been significant interest in halting and even reversing the trend of increasing asthma mortality and morbidity. One strategy is to recognize persistent asthma within the first few years of onset and to intervene early with anti-inflammatory therapy. This review summarizes the new information available on asthma pathogenesis that has helped to shape a change in direction of viewing asthma as an episodic disease to one that is chronic in nature. At the root of this change is the recognition that asthma is a chronic inflammatory disease of the airways. Inhaled steroids are recognized as the most potent anti-inflammatory medication available, and they are now profiled as the cornerstone in the management of chronic persistent asthma. This dramatic change in direction has significant implications for the primary care physician, especially the pediatrician, who is most likely to see asthma in its early stages. Recent interest has been directed toward defining a "window of opportunity" for intervention that could significantly affect the course of the disease. Although this may be an exciting opportunity to control the development of asthma, one has to be cognizant of potential risk of early and long-term therapeutic intervention. This review provides a perspective on our present knowledge and the rationale for early intervention, as well as speculates about how this new information will continue to play a role in advancing asthma care and moving toward a "cure" of this disease.
Szefler
S J
SJ
University of Colorado Health Sciences Center, USA.
D000085:Acetates / Q000627:therapeutic use*; D000280:Administration, Inhalation; D000328:Adult; D018927:Anti-Asthmatic Agents / Q000627:therapeutic use*; D001249:Asthma / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D002648:Child; D003521:Cyclopropanes; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D020024:Leukotriene Antagonists / Q000627:therapeutic use*; D012123:Pulmonary Ventilation; D011804:Quinolines / Q000627:therapeutic use*; D012307:Risk Factors; D012720:Severity of Illness Index; D013440:Sulfides; D013806:Theophylline / Q000627:therapeutic use
D000085:Acetates; D018927:Anti-Asthmatic Agents; D003521:Cyclopropanes; D005938:Glucocorticoids; D020024:Leukotriene Antagonists; D011804:Quinolines; D013440:Sulfides; D013806:Theophylline; C093875:montelukast