The primary physiological alteration in the development of asthma is:

Spasm of bronchial smooth muscle

Asthma is the presence of bronchial spasms. This spasm can be brought on by allergies or anxiety. Answer A is incorrect because the primary physiological alteration is not inflammation. Answer B is incorrect because there is the production of abnormally viscous mucus. not a primary alteration. Answer C is incorrect because infection is not primary to asthma.