For and against. Should steroids be the first line treatment for asthma?

FOR Evidence for the inflammatory basis of asthma comes from bronchial biopsies, which show inflammation of the mucosa even in patients with mild intermittent asthma. Mucosal oedema and excess mucus production cause reduction in the lumen and obstruction to airflow. Bronchospasm occurs as the natural “foreign body” response to irritation caused by inflammation, the bronchi become hyperactive and the airflow is further reduced. Persistent inflammation may lead to structural changes in the airways, with reduction in lung function and irreversible airways obstruction.