The Complex Airway in Childhood Asthma

This review seeks to broadly inform the general reader of current thinking regarding the inter-relating components involved in childhood asthma pathogenesis. A holistic approach, typical of the practicing clinician’s perspective is used, to catalog the major cell effectors and molecules involved in asmogenic processes. Developmental characteristics of infants and children that put them at increased risk for wheezing illnesses and asthma are briefly reviewed. Contemporary theories that purport to explain the emergence of asthma in children are discussed and their intersections are highlighted. Although the allergic paradigm remains privileged among asthma theories, its limitations are reviewed. Roles of major cell effectors and selected recent research on their roles in asthma are described, including mast cells, basophils, eosinophils, neutrophils, alveolar macrophages, and Th-2 lymphocytes. Characteristics of diverse molecules and their relationships with cells and each other are described. Fundamental clinical features of asthma are reviewed with recent relevant findings. New directions in research with promising potential for treatment are discussed.