Asthma consists of wheezing with airway hyper-reactivity, inflammation that is clearly visible in the sub-epithelial compartment, and airway "remodeling". Although subgroups of asthma can be delineated indicating that is unlikely to represent one disease or one pathogenic mechanism, there are concepts that are germane to the vast majority of patients. Under normal circumstances, the pulmonary vascular endothe-lium is one of the major sites of control of bradykinin formation, and drugs such as angiotensin converting enzyme (ACE) inhibitors can upset the balance and lead to either persistent cough, or angioedema that resembles that of hereditary angioedema (or acquired C1 inhibitor deficiency) and is potentially fatal. I will briefly discuss each of these pathologic events focusing on the associated inflammatory mechanism.
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