Allergy Asthma Immunol Res.  2010 Jul;2(3):172-176. 10.4168/aair.2010.2.3.172.

Evolution of Asthma Concept and Effect of Current Asthma Management Guidelines

• Makino S
• Sagara H

• KMID: 2133804
• DOI: http://doi.org/10.4168/aair.2010.2.3.172

Abstract

Concept of asthma has changed from symptom-complex or airway hypersensitivity to airway inflammation and airway remodeling. Based on this concept asthma management guidelines (JGL) has been developed in Japan. Death from asthma has decreased drastically since the publication of the guidelines, although it is still high in elderly population. Further works are expected for "zero-death" from asthma and for tighter control of airway inflammation and resultant airway remodeling.

Keyword

Asthma; concept; guideline; airway remodeling

MeSH Terms

Aged
Airway Remodeling
Asthma
Humans
Hypersensitivity
Inflammation
Japan
Publications

Figure

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  Fig. 1 Evolution of Asthma Concept from Makino S.2 ATS, American Thoracic Society; ICR, International Consensus Report; JGL, Japanese Asthma Prevention and Management Guidelines; GINA, Global Initiative for Asthma.

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  Fig. 2-1 Smad7 seems to suppress thickening of bronchial basement membrane in asthma.15 MB: Basement membrane of the epithelium.

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  Fig. 2-2 p-Smad2 expression level in bronchial epithelial cells was elevated in asthma. Basement membrane thickness was correlated with Smad2 expression level in the airway of mild to severe asthmatics.14

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  Fig. 3 Time course of decrease of death from asthma in Japan. Five years after JGL publication death from asthma has started to decrease continuously.

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