The treatment of asthma aims to keep the airways as normal as possible. They become narrowed because of mucosal inflammation and contraction of bronchial muscle. This mucosal inflammation is present even in the absence of symptoms,1 and probably causes the bronchial hyperreactivity so characteristic of asthma.2 If it is not treated adequately, the narrowing of the airways may become permanent.3 Bronchodilators treat symptoms but have no effect on the underlying inflammation. The early use of anti-inflammatory drugs might reverse this sequence, although there is no direct evidence that it alters the natural history of the disease.
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