Initial information on asthma pathology was based on macroscopic examination of lungs obtained from patients who died of asthma attacks. During autopsy, the lungs appear to be overdistended and fail to deflate. The lungs are usually edematous and congested. The large and small airways are occluded by mucous plugs (now called eosinophil plugs), and their walls are significantly thickened. Dunnill described the pathological changes associated with status asthmaticus and showed that there is mucous obstruction, marked increase in goblet cells, and luminal mucus in peripheral airways.<sup>42 Dunnill M.S. The pathology of asthma, with special reference to changes in the bronchial mucosa J Clin Pathol 1960 ;  13 : 27  [cross-ref]

Cliquez ici pour aller à la section Références</sup> Fiberoptic bronchoscopy now makes it possible to obtain bronchoalveolar lavages (BAL) and bronchial biopsies from patients with mild and moderate asthma and is a useful tool in monitoring disease activity and response to various treatments. During the last few years a large number of studies using these techniques have furthered the understanding of asthma pathology and pathogenesis. Histopathological changes associated with asthma include epithelial changes, such as shedding and desquamation; goblet cell hyperplasia; submucosal gland hypertrophy; thickening of the basement membrane (subepithelial fibrosis); inflammatory cell infiltration; hyperplasia and hypertrophy of the bronchial smooth muscle; and vascular changes.

Corticosteroids (CSs) are the most effective drugs in the treatment of asthma. They cause marked improvement in airway inflammation and lung function. The mechanisms by which CSs resolve the inflammatory process in asthma, especially at the molecular level, are better, although still not fully, understood. This article focuses on the effects of CSs on the structural changes of the lungs in asthmatic patients and discusses possible mechanisms for these effects.