Patient description: A 39-year-old man came to the clinic with cough and shortness of breath that was not relieved by his inhaler. He had these symptoms for 5 days during the past 2 weeks. He doubled his oral corticosteroids in the past week. He is a chef with a history of asthma for 3 years, suffering from frequent cough, wheezing, and shortness of breath and chest tightness. The symptoms become more bothersome within 1-2 hours of starting work every day and worsen throughout the work week. His symptoms improve within 1-2 hours outside the workplace. Spirometry was performed revealing a forced expiratory volume in the first second (FEV1) of 63% of the predicted. His past medical history is significant for seasonal allergic rhinitis in the summer. He doesn't smoke or use illicit drugs. His family history is significant for asthma in his father and sister. He currently uses inhaled corticosteroid (ICS) and fluticasone 500 mcg/salmeterol 50 mcg, one puff twice daily.

Clinical trial eligibility criteria: eligible ages (years): 18.0-60.0,  Asthma Male or female between 18 and 60 years of age 2. Non-asthmatics and mild asthmatics as defined below Non-asthmatic must have no prior diagnosis of asthma, no history of health care utilization or medication use for asthma, no current symptoms, and Forced Expiratory Volume in 1 Second (FEV1) greater than or equal to 80% predicted Asthmatics must have physician-diagnosed asthma for at least one year and evidence of mild, persistent disease during the month prior to Visit 1 (based on 2008 GINA guidelines). a) Participants who are currently taking a controller medication must: i. use the equivalent to GINA Step 1 or 2 therapy; and ii. have controlled disease, as defined by daytime symptoms less than or equal to 2 times week, such as wheezing, tightness in the chest, shortness of breath, and cough no nocturnal symptoms; b) Participants who are not currently taking a controller must have: i.<TAB>daytime symptoms > 1 time a week but < 1 time a day, such as wheezing, tightness in the chest, shortness of breath, and cough; ii. nocturnal awakenings > 2 times a month but < 1 time a week; c) All asthmatic participants must have either: i.<TAB>Pre-bronchdilator FEV1 greater than or equal to 80% predicted and a positive methacholine challenge (PC20 less than or equal to 4 mg / ml); or ii.<TAB>Pre-bronchodilator FEV1 < 80% and post-bronchodilator FEV1 greater than or equal to 80% with significant bronchodilator reversibility (at least 12% or 200ml change in FEV1) 3. Participants must be able to understand and provide written informed consent 4. Participants must be able to travel to the CRU and the EPA  Use of oral steroid treatment(s) within 30 days of Visit 1 2. Acute asthma-related healthcare utilization within 30 days of Visit 1, such as ED visits, systemic corticosteroids, and nebulizer treatment for asthma exacerbation 3. Known or suspected respiratory infections within 30 days of Visit 1, such as flu, pneumonia, severe cold, tuberculosis, or bronchitis 4. Known or suspected viral infection within 30 days of Visit 1 5. History of chronic obstructive pulmonary disease other than asthma 6. History of immunological disease or current cancer 7. Uncontrolled cardiovascular disease such as angina, prior myocardial infarction, stroke, and high cholesterol 8. Cardiac malformations 9. Pulmonary hypertension 10. Bleeding disorders 11. Facial deformity, major facial surgery 12. Currently pregnant or breast feeding 13. Current smoker, significant second-hand smoke exposure (defined by urine cotinine > 100 ng/ml at Visit 1 or Visit 2) or former smokers (defined by a history of smoking > 100 cigarettes) 14. Insulin dependent diabetes 15. Used any of the following medications within 30 days of Visit 1: oral corticosteroids, systemic immunosuppressants or other immune-modifying drugs [e.g., Rituxan, Humira, Enbrel, Azathioprine (Imuran), Cyclosporine (Neoral, Sandimmune, and SangCya), cyclophosphamide, TNF antagonists], anticoagulants (clopidogrel, heparin, enoxaparin and related drugs, coumadin), and sustained use (i.e. more than one dose per day for more than two days) of non-steroidal anti-inflammatory drugs (aspirin, ibuprofen, indomethacin) within seven days of bronchoscopy 16. Allergy or history of adverse reactions to methacholine or lidocaine 17. Severe asthma as defined by a history of intubation for unstable asthma 18. Any condition that, in the investigator's opinion, places the participant at undue risk for complications (e.g. from PFTs, fiberoptic bronchoscopy, bronchalveolar lavage and/or bronchial brushings) 19. Temperature > 37.6 C; blood pressure < 90/50 mm Hg or blood pressure >170/95 mm Hg; pulse rate < 50 or > 100 beats/minute 20. Body weight < 50 kg (<110 lbs) 21. The following abnormal lab values (values obtained during clinical assessment) Platelet count < 100,000 per 10(9)/L White blood cells count < 3000 per 10(9)/L Hematocrit < 35% for both female and male Prothrombin Time (PT) / Abnormal International Normalized Ratio (INR) and partial prothromboplastin time (PTT) based on reference laboratory established reference ranges Serum creatinine > 1.4 mg/dL