Inflammation in airways diseases

Asthma is a chronic airway disease that affects almost 300 million people worldwide. The disease is characterised by episodic respiratory symptoms such as wheeze, dyspnea, chest tightness and cough, together with periodic attacks that vary in severity but can be fatal. The prevalence of asthma has risen dramatically over the past 60 years, for, as yet, unexplained reasons. The defining characteristic of asthma is variable expiratory airflow obstruction, due to bronchial smooth muscle contraction, airway inflammation and the consequences of these processes. The work presented in this thesis addresses the airway inflammatory component of asthma, looking at measurement of inflammation in clinical and research practice, and using this information to probe mechanisms and direct treatment. A key outcome has been the recognition of the heterogeneity of airway inflammation in asthma, and the impact this has on treatment responses, leading to a recommendation for individualised management of the disease.