Timeline of asthma

This is a timeline of asthma.

Sample questions

The following are some interesting questions that can be answered by reading this timeline:

Big picture

Time period	Development summary	More details

Full timeline

Year	Event type	Details	Country/location
c. 1550 BCE	Early description / inhalation therapy	Ancient Egyptian medical sources (including the Ebers Papyrus tradition) describe breathing distress consistent with asthma-like attacks and recommend inhalation of vapors from heated herbal preparations, one of the earliest recorded “inhalation therapy” approaches.	Ancient Egypt
c. 400 BCE	Terminology / triggers	Hippocrates uses the term “asthma” (panting/shortness of breath) and associates attacks with triggers such as cold air, exertion, and certain environments, establishing asthma as a recognizable clinical pattern.	Ancient Greece
c. 100–200 CE	Mechanistic ideas (spasm, mucus)	Greco-Roman physicians (e.g., Aretaeus of Cappadocia, Galen) describe episodic breathlessness and propose airway narrowing (“spasm”) and excess mucus as contributing mechanisms, anticipating later obstruction concepts.	Roman Empire
1190s	Preventive management	Maimonides writes a dedicated treatise on asthma emphasizing prevention through clean air, climate, diet, and avoidance of provoking conditions, an early systematic trigger-control framework.	Egypt
1698	Landmark monograph	English physician John Floyer publishes A Treatise of the Asthma, providing a detailed clinical description of asthma attacks and early modern theories of causation and management.	England
1810s–1890s	Clinical differentiation	19th-century clinicians increasingly distinguish “bronchial asthma” (episodic, often reversible wheeze and airflow obstruction) from chronic bronchitis/emphysema and cardiac causes of dyspnea, helped by auscultation and improved clinical classification.	Europe
1846	Lung function measurement	British surgeon John Hutchinson introduces the spirometer and coins “vital capacity,” establishing the first widely used objective measurement of lung function, a foundation for later asthma diagnosis and monitoring.	United Kingdom
1860	Symptom documentation (wheeze physiology)	Henry Hyde Salter publishes On Asthma: Its Pathology and Treatment, a major 19th-century clinical work emphasizing asthma’s episodic nature, nervous system involvement, and the importance of triggers and environment.	United Kingdom
1892	Pharmacologic bronchodilation (xanthines)	Xanthine derivatives (including early forms of theophylline-class compounds) begin to appear in clinical practice as bronchial smooth-muscle relaxants, foreshadowing 20th-century methylxanthine use in asthma.	Europe
1900s–1930s	Modern rescue bronchodilation	Systemic bronchodilators and rescue medicines such as epinephrine/adrenaline, ephedrine, and theophyllines become common, shifting acute treatment toward pharmacologic reversal of airway narrowing.	United States / Europe
1906	“Allergy” concept coined	Austrian pediatrician Clemens von Pirquet introduces the term “allergy,” providing a conceptual framework that later becomes central to understanding allergic asthma and sensitization.	Austria
1901–1902	Allergy science precursor	Early 20th-century work on hypersensitivity and “anaphylaxis” helps build the immunologic framework that later explains allergic asthma and sensitization mechanisms.	France / Europe
1903	Autonomic pharmacology (anticholinergics)	Anticholinergic plant alkaloids (atropine-like agents) are increasingly discussed as “antispasmodics” for bronchial constriction, reinforcing the bronchospasm model of asthma attacks.	Europe
1910	Mediator discovery (histamine)	Histamine is identified and soon recognized as a key mediator of bronchoconstriction and allergic reactions, contributing to mechanistic models of asthma attacks and allergy-driven airway narrowing.	United Kingdom / Europe
1913	Clinical recognition of occupational asthma	Industrial-era medicine increasingly recognizes asthma provoked by workplace exposures (dusts, chemicals, fumes), strengthening the environmental and occupational trigger model.	United Kingdom / Europe
1922	Ephedrine enters mainstream asthma care	Ephedrine (from Ephedra-derived pharmacology) becomes widely used as an oral bronchodilator, providing an outpatient alternative to injectable adrenaline and shaping early chronic symptom control.	Global
1930	Asthma described as “hyperreactive” airways	Physiologic studies increasingly describe asthma as abnormal bronchial responsiveness to stimuli (cold air, irritants, exercise), anticipating later “airway hyperresponsiveness” as a diagnostic hallmark.	Global
1941	Aeroallergen triggers formalized	Pollen, house dust, animal dander, and molds are increasingly formalized as asthma triggers in clinical allergy practice, linking asthma management to environmental control and immunologic testing.	United States / Europe
1948	Early antihistamines in respiratory allergy	First-generation antihistamines become available and are widely used for allergic symptoms; although limited for asthma control, they influence the broader allergic disease toolkit around asthma.	United States / Global
1948–1950	Systemic corticosteroid era	Cortisone and related systemic corticosteroids enter clinical use and demonstrate powerful anti-inflammatory effects, influencing later asthma management even though early use is limited by systemic side effects.	United States
1950	Status asthmaticus as emergency concept	Severe, persistent asthma attacks (often termed “status asthmaticus”) are increasingly recognized as a medical emergency requiring structured hospital treatment and escalation beyond home rescue remedies.	Global
1956	Inhaler innovation	Pressurized metered-dose inhalers (MDIs) are introduced, enabling portable and rapid inhaled delivery of asthma medicines and transforming outpatient management.	United States
1959	Standardization of spirometry in practice	Spirometry becomes more widely integrated into routine respiratory care, improving objective differentiation of asthma from other chronic lung diseases and enabling response-to-bronchodilator testing.	Global
1960	Air pollution and asthma epidemiology	Modern environmental health research increasingly links air pollution episodes (smog, particulates) with asthma exacerbations and respiratory morbidity, strengthening policy relevance of asthma.	Global
1961	Objective airflow measurement	The Peak expiratory flow (PEF) concept and peak-flow meters become increasingly practical for routine use, enabling home monitoring and early detection of worsening asthma control.	United Kingdom / Global
1963	Pediatric asthma as a major public health issue	Childhood asthma is increasingly documented as a common chronic disease with substantial school absence and family burden, shifting asthma toward a major public health priority.	Global
1967	Allergy mechanism milestone	Discovery of Immunoglobulin E (IgE) provides a clear immunologic mechanism for allergic sensitization and helps formalize allergic (atopic) asthma as a major category.	Sweden / Japan
1968	Selective beta-2 reliever	Salbutamol (albuterol) is introduced and becomes a standard short-acting beta-2 agonist reliever for rapid symptom relief, shaping modern “rescue inhaler” practice.	United Kingdom
1972	Inhaled corticosteroid era	Beclomethasone dipropionate becomes the first widely used inhaled corticosteroid controller therapy, shifting asthma care toward long-term control by suppressing airway inflammation.	United Kingdom / Europe
1974	Early asthma education programs	Structured asthma education programs begin to spread, emphasizing inhaler technique, trigger avoidance, and early self-management concepts that later evolve into action plans.	Global
1977	Airway inflammation evidence	Bronchial biopsy and lavage studies increasingly document chronic airway inflammation in asthma (even between attacks), consolidating the “inflammatory disease” model that supports controller therapy.	Global
1981	Modern ICS expansion	Budesonide is introduced as an inhaled corticosteroid controller, expanding long-term anti-inflammatory options and helping standardize inhaled steroid maintenance therapy.	Sweden / Europe
1986	First leukotriene pathway advances	Leukotriene biology becomes increasingly linked to bronchoconstriction and inflammation, accelerating drug development that later yields leukotriene receptor antagonists for asthma control.	Global
1989	Recognition of airway remodeling	Research increasingly highlights structural airway changes (thickened basement membrane, smooth muscle changes) in persistent asthma, shaping long-term goals beyond symptom relief.	Global
1990	Long-acting bronchodilator era (LABA)	Salmeterol is introduced as a long-acting beta-2 agonist (LABA), improving symptom control and night-time asthma when combined appropriately with anti-inflammatory therapy.	United Kingdom / Europe
1991	Written action plans expand	Personalized written asthma action plans become more common in clinical guidance, helping patients adjust reliever/controller therapy and seek timely care during worsening symptoms.	Global
1992	HFA transition in inhalers begins	Environmental phase-out of ozone-depleting CFC propellants accelerates development and adoption of HFA-based inhalers, modernizing inhaler technology and formulation science.	Global
1993	Airway inflammation biomarker	Measurement of exhaled nitric oxide (Fractional exhaled nitric oxide) emerges as a non-invasive marker of type-2 airway inflammation, supporting phenotype assessment and treatment adjustment in some settings.	Global
1990s	Guideline-based management	International and national guidelines popularize stepwise therapy, objective monitoring (spirometry and peak flow), and written asthma action plans as routine standards of care.	Global
1995	Global strategy framework	The Global Initiative for Asthma (GINA) publishes a major global strategy report that standardizes diagnosis, severity/control concepts, and stepwise long-term management worldwide.	Global
1997	Combination inhaler strategy	Fixed-dose inhaled corticosteroid plus LABA combinations expand, improving adherence and enabling integrated “controller + symptom control” regimens for persistent asthma.	Global
1997	Eosinophilic inflammation emphasized	Blood and sputum eosinophilia gain prominence as markers of “type 2” asthma biology and steroid responsiveness, strengthening biomarker-linked clinical reasoning.	Global
1998	Awareness milestone	The first World Asthma Day is held, expanding global public health attention to asthma education, prevention, and access to effective treatment.	Global
1998	Leukotriene modifier era	Montelukast is introduced as an oral leukotriene receptor antagonist, offering a non-steroid controller option for some patients (especially with allergic rhinitis or exercise-triggered symptoms).	United States / Global
1999	Asthma control becomes a core endpoint	“Control” (symptoms, activity limitation, rescue use, lung function, exacerbations) becomes a central clinical target rather than “severity” alone, reshaping treatment goals.	Global
2001	Standardized severity classification	National and international strategies increasingly formalize severity categories (intermittent to severe persistent), improving comparability in trials and clinical decision-making.	Global
2003	First biologic therapy (anti-IgE)	Omalizumab (anti-IgE monoclonal antibody) is approved for allergic asthma, beginning the biologic era for severe asthma management.	United States
2004	Child wheeze phenotypes described	Cohort studies increasingly distinguish early transient wheeze, persistent wheeze, and late-onset wheeze phenotypes, improving pediatric asthma risk modeling and research stratification.	Global
2006	Severe asthma standardization	Severe/refractory asthma is increasingly formalized as a distinct clinical category in research and guidelines, focusing attention on exacerbation risk, corticosteroid burden, and specialized care pathways.	Global
2008	Severe asthma referral pathways expand	Specialist severe-asthma clinics and referral pathways grow, emphasizing exacerbation prevention, steroid-sparing, adherence review, and comorbidity management.	Global
2010	Endotype-driven management	“Phenotypes” and “endotypes” (especially type-2/eosinophilic asthma) become mainstream in specialist practice, setting the stage for biomarker-guided escalation using eosinophils, IgE profiles, and FeNO.	Global
2011	“Treatable traits” concept emerges	Airway disease management increasingly adopts “treatable traits” logic (eosinophilia, allergy, adherence, rhinitis, obesity, smoking exposure), supporting individualized escalation strategies.	Global
2014	Biologic class diversification	Biologic therapies broaden beyond anti-IgE toward targeted cytokine pathways, accelerating precision medicine for severe asthma and reducing exacerbation rates in selected patients.	Global
2015	Type-2 targeted biologics	Anti-IL-5 biologic therapies (e.g., mepolizumab) are approved for severe eosinophilic asthma, accelerating phenotype-guided treatment for difficult-to-control disease.	United States
2016	Anti-IL-5 biologic expansion	Anti-IL-5 pathway biologics expand beyond early approvals, broadening options for severe eosinophilic asthma and reducing exacerbations in selected patients.	United States / Global
2017	Anti-IL-5 receptor strategy	Anti-IL-5 receptor biologic therapy (e.g., benralizumab class) strengthens targeted control of eosinophilic inflammation and enables steroid-sparing approaches in severe asthma.	United States / Global
2018	IL-4/IL-13 pathway targeting	Biologics targeting IL-4/IL-13 signaling expand treatment for type-2 asthma with comorbid atopic disease, reinforcing personalized therapy based on inflammatory pathways.	United States / Global
2019	SABA-only strategies discouraged	Major guideline trends increasingly discourage short-acting bronchodilator-only treatment for most adolescents/adults, emphasizing inflammation control and exacerbation prevention as first principles.	Global
2019–present	Exacerbation prevention focus	Modern practice increasingly discourages “reliever-only” treatment for most patients and emphasizes anti-inflammatory strategies, individualized risk reduction, adherence checks, and comorbidity management to prevent severe attacks.	Global
2020	Telemedicine for asthma management expands	Remote visits and digital monitoring accelerate in routine asthma care, supporting medication review, adherence checks, and patient education outside clinic settings.	Global
2021	Non-type-2 targeting (TSLP)	Anti-TSLP biologic therapy broadens severe asthma treatment beyond classic allergic/eosinophilic categories, supporting the concept of upstream “alarmin” pathway modulation.	United States / Global
2022	Focus on equity and access	Global health efforts increasingly frame asthma outcomes around access to inhaled corticosteroids, quality-assured inhalers, and clean-air interventions, highlighting inequities across countries and regions.	Global
2024	Personalized escalation becomes mainstream	Clinical practice increasingly integrates biomarkers, exacerbation history, and comorbidity assessment into tailored step-up/step-down plans, reinforcing asthma as a heterogeneous syndrome rather than a single disease.	Global
2020s	Digital adherence and smart inhalers	Smart inhalers, connected peak-flow devices, and remote monitoring expand real-world asthma management by tracking adherence, technique, and rescue use patterns, supporting earlier intervention and individualized care.	Global

Meta information on the timeline

How the timeline was built

The initial version of the timeline was written by FIXME.

Funding information for this timeline is available.

Feedback and comments

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What the timeline is still missing

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