Strategies for the primary prevention of Asthma

Significant advances have occurred during the last decade in our understanding of the pathogenesis of asthma. The appreciation that asthma has a significant inflammatory component and that this component is associated with chronicity of symptoms and bronchial hyperresponsiveness (1) led to crucial improvements in therapeutic strategies to successfully treat the disease. Expert panels in the United States (2) and at an international level (3) proposed consensus guidelines for the treatment of the different expressions of asthma. Although there were slight differences between the different guidelines, they all conveyed a central concept: successful treatment of the disease requires long-term use of antiinflammatory medication, especially in subjects with persistent symptoms. There is now convincing evidence that this strategy allows most individuals with asthma to lead a normal life.