Three factors contribute to airway obstruction in asthma: (1) contraction of the smooth muscle that surrounds the airways; (2) excessive secretion of mucus and in some, secretion of thick, tenacious mucus that adheres to the walls of the airways; and (3) edema of the respiratory mucosa. Spasm of the bronchial smooth muscle can occur rapidly in response to a provocative stimulus and likewise can be reversed rapidly by drug therapy. In contrast, respiratory mucus accumulation and edema formation are likely to require more time to develop and are only slowly reversible.
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