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Therapy of bronchial hyper‐responsiveness

Bronchial hyper-responsiveness (BHR) is an important feature of bronchial asthma, which is linked to inflammatory events within the airway wall and lumen [1,2]. For diagnostic purposes and follow-up of the disease, BHR is most often measured using inhalation protocols with histamine or methacholine. The degree of BHR was reported to reflect the severity of the disease [3,4] and to predict the prognosis of childhood asthma [5]. However, the relationship between bronchial reactivity and asthma symptoms in adults has been questioned [6]. Furthermore, in children, Pattemore et al. [7] found major discrepancies between the prevalence of asthmatic symptoms and the prevalence of BHR. It has therefore been suggested that the degree of BHR is only one feature to evaluate the course of the asthmatic disease [8]. The ultimate task of asthma treatment is the relief of symptoms to permit a normal style of life. The main measures to achieve this are focusing on the decrease of airflow obstruction and the shift of BHR towards a normal range [9], Bronchial asthma is a chronic disease that requires long-term, or even life-long treatment. Therefore, studies on the effects of long-term treatment with relevant anti-asthma drugs are of utmost importance. The role of bronchodilating compounds in asthma therapy has been recently summarized [10], This paper reviews the current knowledge on the influence of antiasthma drugs on BHR, with special reference to longterm treatment.