What is the primary mechanism of pathology in asthma?

The primary mechanism of pathology in asthma is indeed obstruction due to inflammation of the airway. In asthma, the airways become hyperresponsive to various stimuli, leading to an inflammatory response. This inflammation results in swelling and increased mucus production, ultimately narrowing the airways and causing obstruction during airflow, particularly during expiration.

The inflammatory mediators released during an asthma attack contribute to bronchoconstriction, which is the tightening of the smooth muscles surrounding the airways. This process limits airflow, making it difficult for individuals to breathe and often results in wheezing, coughing, chest tightness, and shortness of breath.

While viral infections and environmental toxins can trigger or exacerbate asthma symptoms, they are not the primary mechanism of the disease itself. Rather, they may act as contributing factors. Structural lung changes can occur over time due to chronic asthma and may include airway remodeling, but these are subsequent to the primary inflammatory process and not the main mechanism of pathology.

Understanding that the core issue in asthma is the inflammatory obstruction helps in grasping the therapeutic approaches used, such as anti-inflammatory medications and bronchodilators aimed at reducing inflammation and relieving symptoms.