Patient description: The patient is a 15-year-old boy with asthma diagnosed a year ago. He presents with shortness of breath, chest tightening and cough. According to his mother, he didn't respond to the usual corticosteroid inhaler. He was admitted to the emergency department with diagnosis of severe asthma exacerbation. He is a candidate for general corticosteroid therapy. Spirometry revealed a forced expiratory volume in the first second (FEV1) of 60% of the predicted. His past medical history is non-significant. His family history is significant for asthma in his mother and his uncle. He used to be treated with combination of inhaled corticosteroids and Zafirlukast.

Clinical trial eligibility criteria: eligible ages (years): 12.0-17.0,  Asthma for all subjects: 1. Self-identified as African-American 2. Ages 12-17 years 3. Live within convenient driving distance of the UNC Rex Clinic in Raleigh, NC. 4. Physician-diagnosis of moderate-to-severe persistent asthma 5. Current treatment with appropriate therapy for moderate-to-severe persistent asthma symptoms as per the NHLBI guidelines including: Daily controller medication use for asthma requiring at least a medium-dose inhaled corticosteroids (ICS) or a low dose ICS + long-acting beta2 agonist (LABA) combination. Subjects may use daily or every other day oral corticosteroids for control of asthma symptoms for well-controlled asthmatics (from NHLBI guidelines): 1. Nighttime awakening with asthma symptoms ≤ 2x/month over the past 6 months 2. Use of short-acting beta2 agonist for symptom control ≤ 2 days /week over the past 6 months 3. Asthma Control Test score >19. The Asthma Control Test is a standardized clinical tool to assess asthma control over the previous 4 week period (attached). 4. Baseline FEV1(pre-albuterol) > 80% of that predicted for gender, ethnicity, age and height (NHANES III predicted set) for poorly-controlled asthmatics (from NHLBI guidelines): 1. Nighttime awakening with asthma symptoms > 2x/month over the past 6 months 2. Use of short-acting beta2 agonist for symptom control > 2 days /week over the past 6 months 3. Asthma Control Test score <19. The Asthma Control Test is a standardized clinical tool to assess asthma control over the previous 4 week period (attached). 4. Baseline FEV1 (pre-albuterol) < 80% of that predicted for gender, ethnicity, age and height (NHANES III predicted set)  for all subjects: 1. Children younger than age 12 and older than 17 2. Children unable to perform spirometry 3. Medical history or underlying health problems that may preclude participation in the protocol per the study physician (including but not limited to cystic fibrosis, chronic bronchitis, recurrent pneumonia, immunodeficiency, hematologic disorders) 4. History of bleeding disorder or anemia 5. Subjects and families unwilling to travel to the clinic for the required 6 visits 6. Unwilling or unable to refrain from the following medications for the week prior to the study as well as the week of the study including fish oil; anti-inflammatory agents such as ibuprofen (Advil, Motrin), naproxen (Aleve) or aspirin as needed**. Acetaminophen (Tylenol) is allowed.**If the child requires anti-inflammatory medications for a fever or joint/muscle pain, in the week prior to the study visit, all subsequent visits may be rescheduled. 7. Other uncontrolled health problems 8. Non-English speaking subjects