The management of asthma needs to be responsive to the characteristics that define asthma. Asthma is a chronic inflammatory disorder of the airways. Many cells and cellular elements play a role. Airway inflammation causes recurrent episodes in asthma patients of wheezing, breathlessness, chest tightness, and coughing, particularly at night and in the early morning. These episodes of asthma symptoms are usually associated with widespread but variable airflow obstruction that is often reversible either spontaneously or with treatment.
Airway obstruction is caused by a variety of changes in the airway.
Inflammation causes an associated increase in the existing airway hyperresponsiveness to a variety of stimuli. These stimuli or precipitants result in airflow obstruction and asthma symptoms in the patient with asthma. The relationships between these characteristics are illustrated in the figure below. The condition of a patient's asthma will change depending on the environment, patient activities, management practices, and other factors. Viewed microscopically, airways are infiltrated with eosinophils and mononuclear cells, and there is vasodilation and evidence of microvascular leakage and epithelial disruption.