Control of inflammation in asthma: requirements for an effective intervention

Asthma is an inflammatory disease affecting both large and small airways (bronchioles with an internal diameter of 0.5-2 mm). The inflammation, especially when uncontrolled, may cause an airways remodelling which is the basis of chronic symptoms, hyperreactivity, and obstructive alterations in respiratory function tests. Drugs able to attenuate the inflammation and improve airway patency are fundamental for controlling the disease, and they should reach all sites of pathologic derangement. Compared to classic chlorofluorocarbon (CFC)-propelled metered dose inhalers (pMDIs), the new hydrofluoroalkane (HFA)-pMDIs and the Modulite (R) technology deliver extrafine particles that can also reach the small airways enabling a global control of the asthmatic syndrome.