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Asthma is estimated to affect 15 million people in the United States. After declining in the 1970s, its prevalence, morbidity, and mortality have increased since the 1980s. It now affects 1 in 7 children in the United Kingdom, and is the most frequent reason for preventable childhood hospitalizations in the United States. In 1990, total asthma-related health care costs were estimated at 6.2 billion dollars in the United States. This figure exceeded 10 billion dollars by 1995.

Asthma used to be thought of as an entirely reversible disorder. As a consequence, our therapeutic approach to asthma has focused on symptomatic control through the alleviation of bronchospasm and the reduction of airway inflammation. It is now known, however, that this optimistic picture of the natural history of asthma is not entirely complete. A number of studies have demonstrated that asthmatics, as a group, experience an accelerated rate of …