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While the critical role of inflammation has been further substantiated, there is evidence for considerable variability in the pattern of inflammation indicating phenotypic differences that may influence treatment responses. Gene-by-environmental interactions are important to the development and expression of asthma. Of the environmental factors, allergic reactions and pollution are of critical importance with expanding role of viral respiratory infections in these processes. The onset of asthma for most patients begins early in life with the pattern of disease persistence determined by early, recognizable risk factors including atopic disease, recurrent wheezing, and parental history of asthma. Current asthma treatment with anti-inflammatory does not appear to prevent the progression of the underlying disease severity. Asthma is truly a syndrome encompassing several disease entities/endotypes. The word asthma derives from the Greek word for panting, or breathlessness, and thus describes the primary symptom of this disease.
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