Recent advances in asthma

There have recently been important advances in our understanding of asthma mechanisms and treatment. Asthma is now recognized as a disease of the airways which involves a special type of inflammation, characterized by the presence of activated mast cells, eosinophils and T-lymphocytes. There has been a growing recognition that chronic rather than acute inflammatory events are more relevant to understanding the underlying mechanisms in asthma and the role ofcytokines, as mediators of chronic inflammation, has been an area of very rapid development. At the same time the approach to asthma treatment has changed, with a much greater emphasis on the earlier and more widespread use of inhaled anti-inflammatory drugs, and particularly inhaled steroids. There has also been an increased understanding of the mechanisms of action of existing anti-asthma therapies, but at the same time questions have been raised about the safety of some treatments. This has prompted the search for novel anti-asthma therapies, based on our current understanding of pathophysiological mechanisms. The literature on asthma is vast and we do not intend to provide an exhaustive or comprehensive review, but have concentrated on some areas where there have been advances in knowledge which have clinical and therapeutic relevance.