The Anatomical and Biochemical Basis of Bronchial Obstruction in Asthma

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Abstract
An integrated view of the anatomical and biochemical changes in the bronchial tree which lead to obstruction in asthma is presented. This is preceded by a review of the basic gross and microscopic anatomy of the normal bronchial system and a description of the innervation of the airways, the control of bronchomotor tone, and mucous formation and ciliary activity. The gross and microscopic pathology of asthma and some characteristics of asthmatic sputum are discussed. The chemical mediators which may be involved in the production of bronchoconstriction in asthma are discussed in some detail in terms of their origin, nature, distribution, mechanism of formation or release in immunologic reactions, effect on the bronchial system, metabolism and antagonists. Included in the survey are histamine, slow-reacting substance, acetylcholine, bradykinin and 5-hydroxytryptamine.