Is Asthma an Inflammatory Disease? A New Review Looks at Breathing Exercises as an Add-On

Is asthma an inflammatory disease?

Yes. Researchers describe asthma as "a common chronic inflammatory disease of the airways."3 It is one of the most common long-term diseases in the world. It narrows the airways on and off, and that brings on shortness of breath and wheezing.4

The inflammation has a usual pattern. In most people with asthma, it comes from long-running activity in the type 2 branch of the immune system.3 Immune cells release signaling proteins called IL-4, IL-5, IL-9 and IL-13, which feed the swelling in the airways.3

But asthma is not one disease with one pattern. Many people with severe asthma show little type 2 inflammation, which points to other immune drivers.3 Body weight changes the picture too. A meta-analysis of 40 studies found that adults with asthma and obesity had a different pattern of inflammation. Their airways held more of a white blood cell called a neutrophil, and their blood had higher CRP and IL-6.8 CRP and IL-6 are proteins that rise when there is inflammation in the body.

Do asthma inhalers reduce inflammation?

Some do. Asthma inhalers come in two main kinds. One opens the airways fast for relief. The other holds an inhaled steroid, which is the regular, preventive part of treatment.6 Steroids are the mainstay drugs for asthma, and the immune cells behind type 2 inflammation are highly sensitive to them.3

Breathing exercises helped people feel better without altering the airway inflammation underneath.From a 2026 systematic review in F1000Res

The trial results are strong. A 2025 network meta-analysis pooled 27 randomized trials. Relief inhalers that also held a steroid were linked to fewer severe flare-ups than relief inhalers alone, with high certainty.5 A 2021 Cochrane review of people with mild asthma found the same pattern. Over the trials, 109 of every 1,000 people on a reliever alone had a flare-up that needed steroid pills, compared with 52 of every 1,000 on the combined inhaler.6 The combined inhaler also lowered FeNO.6

FeNO, short for fractional exhaled nitric oxide, is a gas you breathe out. It is a no-needle marker of type 2 inflammation in the airways.7 Keep it in mind, because it is the number that matters in the new review.

What the new review on breathing exercises found

Here is the puzzle. Asthma has very good treatments, and most people can get good control.4 Yet even with the best medicine, a large share of adults with asthma still have symptoms.1

Part of the reason may be how they breathe. Some people with asthma breathe too fast or too much, or move air in an odd way. Medicine does not fix that well.1 Doctors call it dysfunctional breathing, and it is common and leads to worse asthma outcomes.9

So a team in Spain asked whether breathing exercises help as an add-on. They searched studies from 2013 to March 2025 and found 6 that fit, with 1,098 adults in all. Four were randomized trials.1

Several studies found better quality of life and better scores on asthma control tests.1 One method, called Buteyko, gave fairly steady results, including about 20% less use of rescue and steroid inhalers.1 In one large trial, an app-style program people followed on their own worked as well as lessons with a physical therapist.1

Then the catch. Lung volumes did not change. Severe flare-ups did not change. And FeNO, the airway inflammation marker, did not change either.1 The authors' conclusion: the exercises seem to help by fixing the breathing pattern, without altering the inflammation underneath.1

How strong is the evidence?

The new review is small, and the study quality scores were middling.1 A bigger 2020 Cochrane review pooled 22 trials with 2,880 adults, most of them testing yoga.2 Breathing exercises improved quality of life at three months, with moderate certainty, based on 4 studies of 974 people.2 Results on asthma symptoms were unclear.2

Exercise programs tell a similar story. A meta-analysis of 9 studies with 418 adults found that exercise-based lung rehab improved quality of life and how far people could walk in six minutes. Asthma control scores did not improve in a clear way.10

The bottom line

Asthma is inflammation in the airways, and the inhaled steroid is what calms it. That part of the story is settled. The new review adds something smaller and kinder: a free set of skills that helped many people breathe easier and feel better, without touching the inflammation itself. Two problems, two tools. Use both, and never trade one for the other.