Bronchial hyperresponsiveness, atopy, airway inflammation, and asthma

Abstract

Airway inflammation particularly with eosinophil infiltration is an almost invariant feature of asthma, though it may not be exclusive to asthma. BHR and atopy are common phenomena in asthmatics but not invariably so. Allergen-induced late asthmatic responses can increase non-specific hyperresponsiveness and bronchial responsiveness in turn is, at least from some studies, correlated with the degree of airway inflammation. Atopy is a major risk factor for the development of asthma and its persistence from childhood into adulthood. Airway inflammation occurs very early in the natural history of asthma. No therapeutic intervention in established asthma has been shown to achieve a cure or even modify the natural history of the disease. Therefore, further studies are urgently required to identify whether strategies of early intervention to prevent the development of airway inflammation will modify the natural history of the disease.

Assessing the Evidence for Remodelling of the Airway in Asthma

“…Airway biopsies from children with non-specific respiratory symp-ASSESSING TISSUE EVIDENCE OF toms, subsequently found to have asthma, have shown REMODELLING eosinophil infiltrates and subepithelial collagen deposition. 13 Contemporary asthma therapies described Over the past decade, endobronchial bronchoscopy in these studies would seem to be capable of producing has become a valuable tool for the investigation of symptomatic control, but may not be sufficient to airway diseases. Small, 1 mm 3 specimens from proxprevent the occurrence of airway remodelling.…”

Individual allergens as risk factors for asthma and bronchial hyperresponsiveness in Chinese children

“…Environmental factors have been thought to be important in determining disease manifestations. Among the suspected environmental factors associated with asthma, allergen sensitization has been most widely implicated as one of the important risk factors [9].…”

Early Immunological Influences

“…Furthermore, bronchial hyperresponsiveness at 4 weeks of age is a clear risk factor for asthma at 6 years of age [81]. The implication of these observations is that the airway inflammation of asthma is initiated in very early life and may be present in many subjects before full-blown disease manifests [82].…”