20. Does early steroid therapy prevent permanent airway damage in asthma?:
There is little doubt about the inflammatory nature of asthma, which involves chronic eosinophilic inflammation of the airway and activation of myofibroblasts in the underlying lamina reticularis. Ultimately the result of all this is airway remodelling associated with increasingly-irreversible airflow obstruction and a decline in lung function. However, what has not been resolved is whether earlier intervention with steroid treatment will prevent the permanent lung damage. Only a large-scale randomised study against a placebo will resolve this issue, meanwhile there are single-centre studies which have shown results going in both directions (i.e. steroids do appear to prevent damage in some studies but not in all), and in a recent report in the Lancet there were clearly benefits/advantages in the group treated on budesonide vs placebo.

Read more:
Indian J Paediatr 2001;68 Suppl(4);53-6
Curr Allergy Asthma Rep 2001;1:127-33
New Engl J Med 1998;339:1194-2000
Respir Med 1994; 88:373-81