Whether airway hyperresponsiveness is a symptom of airway inflammation or airway remodeling, or whether it is the cause of long-term loss of lung function, remains controversial. Some investigators have hypothesized that aggressive treatment with anti-inflammatory therapies improves the long-term course of asthma beyond their salutary effects on parameters of asthma control and rates of exacerbation over time. 13 This contention has been supported by an observational study 14 that found long-term exposure to ICS was associated with an attenuation of the accelerated decline in lung function previously reported in asthmatics; more studies are required to substantiate these findings.
Inhaled corticosteroids are prescribed for patients of all ages to treat different levels of persistent asthma. They work by dampening down the inflammation in the airways, and are the most effective agents for treating asthma. As a result, asthma symptoms and sudden acute attacks occur less often. To be effective, they need to be taken once or twice every day as prescribed by your doctor. They are of no benefit when used for symptoms, unlike bronchodilators or when taken on an odd occasion. Inhaled corticosteroids are a maintenance medicine that helps to prevent severe asthma symptoms.
Airway remodeling is when there are permanent physical changes to the airways that also affects how they work. This may happen after chronic long-term asthma. After cycles of inflammation, damage and repair to the airways. permanent remodeling of the airways may occur. This is when the physical structure of the airway changes. This will cause permanent airway narrowing (they are always more narrow than normal and get narrower during an asthma attack), bronchospasms are more easily triggered (bronchial hyperresponsivenes), airway edema (fluid in the airway), and mucus hypersecretion (too much mucous is made) as well as the build-up of collagen around the airway which is called fibrosis. Airway remodeling has been observed in chldren as young as six.