Steroids and Asthma
It is impossible to read about asthma in the 1990s without being informed that it is an inflammatory disease and that all but the mildest cases require anti-inflammatory therapy for optimal management.1 Bronchoalveolar lavage studies document the influx of inflammatory cells and the upregulation of inflammatory cytokines in bronchial washings of patients with chronic asthma.2 Biopsy specimens confirm an inflammatory cell accumulation and the destructive change to the epithelium that one would expect from this insult.3 The pathophysiology of asthma would seem to justify the use of corticosteroids for its management. A single dose of prednisone can be shown to decrease inflammatory leukotrienes while there is a concomitant increase in forced expiratory volume in 1 second.4