Airways hyper responsiveness to common provocative exposures.

A combination of environmental exposures and inherent biologic and genetic susceptibility has been implicated.

Environmental- Allergens, infections, pollutants, stress and environmental tobacco smoke

• Recurrent wheezing episodes in early childhood are associated with common respiratory viral infections
• Home allergen exposures like in sensitised individuals can initiate airway inflammation
• Environmental tobacco smoke and air pollutants can aggravate airways inflammation and increase asthma severity and drive asthma persistent.
• Young children who experience recurrent wheezing, only a minority go on to have persistent asthma in later childhood.

1. Parental asthma
2. Eczema
3. Inhalant allergen sensitisation

1. Allergic Rhinitis
2. Wheezing apart from cold
3. Food allergen sensitisation

Management are based on individual according to severity and response to treatment.

Principles of treatment –

1. Reducing airway inflammation by minimizing pro-inflammatory environmental exposures.
2. Regular assessment, monitoring and adjusting therapy in children.
3. Daily use of anti inflammatory medications
4. Controlling comorbid conditions that can worsen asthma
5. Less inflammation typically leads to better asthma control, with fewer exacerbations and decrease need for quick reliever asthma medications.