Much of the research in asthma has focused on the multiple proinflammatory mechanisms involved in this complex inflammatory disease (1). Much less attention has been paid to endogenous antiinflammatory mechanisms that may counteract or limit the inflammatory process in asthma. It is possible that these inhibitory mechanisms might be defective, resulting in increased or more prolonged inflammation. Such mechanisms, if deficient, might also be important in determining the severity of asthma, which differs markedly and inexplicably between patients. Little is understood about the factors that determine severity in chronic inflammatory diseases, such as asthma, but it is possible that endogenous inhibitory mechanisms may be of critical importance. There has been relatively little research into endogenous inhibitory mechanisms in asthma, but it is likely that understanding these processes may give a better understanding of disease severity. This may also lead to novel therapeutic approaches, such as drugs that increase the release of endogenous inhibitors or mimic their effects. Such therapeutic approaches are attractive since they may restore antiinflammatory mechanisms to normal and thus carry a lower risk of adverse effects in the long term.
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