Introduction:
Asthma, a chronic lung disease affects about 1 in 13 million Americans and is found in adults and pediatric individuals. Male children are more prone to developing asthma as compared to female children. The trend, however, reverses in adulthood as the testosterone hormone also known as the male hormone elevates during adulthood, decreasing the swelling and narrowing of the airways associated with asthma.
What is Asthma?
Asthma is an inflammatory, non-communicable lung disease characterized by variable expiratory outflow and narrowing of the airways associated with airway inflammation. The symptoms produced are:
- Wheezing chest,
- Cough typically worse at night,
- Chest tightness, and
- Shortness of breath.
The pathophysiological mechanism of asthma consists of three 3 features: bronchoconstriction, thick mucus secretion, and airway inflammation. It is a physical condition requiring treatment and monitoring to manage the asthma disease.
Causes of Asthma:
Asthmatic symptoms and exacerbations are induced by various outdoor and indoor pollutants and are associated with both allergic and non-allergic reactions.
The most common triggers that negatively impact the course of asthma include allergies, air pollution, airborne irritants, and respiratory infections. Factors associated with non-allergic asthma are exercising or physical activity, weather change, emotional setbacks, and some medicines. Some other etiological factors that predispose to asthma are:
- Family history
- Obesity
- Viral respiratory infections
- Smoking
Allergic Asthma:
Understanding the type of asthma helps better manage the condition. No matter what type of asthma is present, all forms of asthma involve some degree of airway inflammation. Allergic asthma is the most common type of asthma and is a conjunction of allergens. The respiratory disorder, asthma is evoked by inhaling an allergen such as pollen from grass, trees, dander, or mold spores. Over 25 million people in the US suffer from asthma in which about 60% of individuals have asthma that is brought on by allergies.
People with allergic diseases have hyper-reactive immune systems meaning their immune systems react to normally harmless substances identifying them as triggers to asthma. When the immune system thinks that there’s danger, it releases a chemical called immunoglobulin E (IgE).
This substance fights back to protect the body. However, high amounts of IgE cause airways to constrict, making it difficult to breathe. The symptoms of allergic asthma are the same as those of people with non-allergic asthma. They consist of coughing, wheezing, chest constriction, and breathing difficulty. Some common allergy symptoms might also be present in people with allergic asthma such as raised IgE levels, runny nose, itching, and red watery eyes.
Treatment for Allergic Asthma:
There are several treatment options available to better manage asthma, these include steroid inhalers, which help fight inflammation, and bronchodilators, which open up airways. An alternate injectable medication combats asthmatic allergy when the conventional treatments don’t provide results.
Difference between Allergic Asthma and Allergy:
Allergies are the body’s protective response to the presence of certain harmless proteins called allergens. The difference between allergic asthma and allergy depends on the location of the reaction. For instance, congested feeling and sneezing are indicative of a reaction occurring inside the nose while coughing, wheezing, and shortness of breath represent a reaction occurring inside the lungs which happens in asthma.
Allergy treatment involves using an anti-allergic injection that works by gradually reducing the immune system’s reaction to specific allergic triggers in an approach called immunotherapy. This lessens symptoms by assisting the immune system in developing a tolerance to the allergens over time. Both environmental and genetic factors play an important role in the onset of allergic asthma.
When an allergic reaction takes place in the lungs, an inhaler is used to deliver the medication directly to the airways and lungs. These inhalers are especially useful because they are used in emergencies like asthma attacks.
The major difference between allergic asthma and nonallergic asthma is that people will allergic asthma usually experience the onset of symptoms after the inhalation of an allergen with the added symptoms of non-respiratory allergy such as hives on the skin. Another key difference is that people with allergic asthma are usually younger and test positive in skin allergen tests.
Allergic Conditions Linked to Asthma:
People with asthma are likely to have other allergic conditions such as
- Atopic dermatitis (eczema)
- Allergic rhinitis (hay fever)
Atopic Dermatitis (Eczema):
Atopic dermatitis is one of the most prevalent chronic inflammatory skin diseases in children frequently associated with respiratory allergy. The predominant characteristics of the condition are skin discoloration, itchiness, and dry skin. Both atopic dermatitis and asthma are inflammatory conditions and are classified as Type 1 hypersensitivity reactions. Over 25% of people with atopic dermatitis develop asthma because of a hyper-reactive immune response in response to an environmental trigger (allergen).
The best way to subside the symptoms of allergic conditions is to avoid exposure to potential triggers and make certain lifestyle changes such as taking lukewarm baths and avoiding the use of fragrant products. Topical ointments also help better control flare-ups in patients with atopic dermatitis.
All the medications used to treat asthma and dermatitis work by controlling the inflammation induced by the immune system.
Allergic Rhinitis (Hay Fever):
Allergic rhinitis, a common comorbidity of asthma is found in about 80% of asthmatics but is often undiagnosed. A strong association exists between asthma and significant risk factors (allergic rhinitis and positive skin allergen test).
Symptoms of allergic rhinitis correspond to that of normal cold and include:
- Runny nose
- Red watery eyes
- Cough
- Itchy nose
Treatment Options Available:
Nasal sprays containing corticosteroids (a type of anti-inflammatory medicine) are the most effective treatments available for managing allergic rhinitis. People with asthma and allergic rhinitis should concomitantly use both a preventer nasal spray and an asthma-preventer inhaler regularly.
Medical Conditions Mimicking Asthma:
- Cardiac asthma: Cardiac asthma is a type of heart failure that mimics some of the symptoms of ordinary asthma but is not the form of asthma. This kind of heart failure results from pneumoedema, a buildup of fluid in and around the airways, producing a specific type of wheezing and cough associated with left-heart failure.
- Sinusitis: Also known as sinus infection, involves inflammation or swelling of the sinus.
- Vocal cord dysfunction
- Respiratory syncytial virus: This virus can lead to childhood asthma typically producing wheezing and pneumonia in babies and younger children.
- COPD
- Hyperventilation or panic attacks
- Gerd: Aspiration of acid as the result of acid reflux in the trachea triggers asthma-like symptoms (coughing, wheezing, pneumonia).
Factors to Consider when Ruling Out Asthma:
Family history, medical history, and accurate reporting of symptoms play a vital role when determining the diagnosis. A variety of tests are conducted to rule out asthma, including blood tests, chest and sinus X-rays, liver function tests, skin allergen tests, and tests for allergies to certain foods to rule out asthma or determine if any other condition is present.
Types of Asthma:
There are many different types of asthma other than allergic asthma brought on by various factors. Examples of non-allergic asthma are as follows:
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Adult-onset Asthma:
The possible causes of adult-onset asthma are obesity, environmental pollutants, respiratory tract infections, stressful events, and active smoking.
Effective long-term and quick-relief medications are available to treat asthma. Examples of the latter are bronchodilators such as short-acting inhaled beta 2-agonists (inhalers) and anticholinergics.
Quick-relief drugs are indicated for the immediate relief of symptoms while long-term medications should be taken every day to keep the symptoms at bay.
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Exercise-induced Asthma:
In about 90% of asthmatics, activity or physical effort causes exercise-induced airway constriction. The symptoms associated with exercise-induced asthma appear within a few minutes of beginning exercise and peak or get worse shortly after quitting. A reliever inhaler provides prompt relief in such cases.
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Occupational Asthma:
Occupational asthma is common in certain professions such as cooks, hairdressers, mechanics, and healthcare professionals caused by the breathing of workplace triggers (chemicals, fumes, animal fur, latex).
Inhaling grain and poultry specks of dust is one of the most common causes of occupational asthma in agricultural workers.
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Non-allergic Asthma:
Non-allergic asthma, also known as non-atopic asthma frequently manifests itself in the later stages. The condition however isn’t brought on by an allergy trigger like pollen or dust.
Summary:
Asthma, a major lung disease, causes clinically considerable morbidity, missed days of work or school, high costs for hospitalization and emergency care, and occasionally death. The illness is brought on by allergens and other triggers that emerge at specific times of the year, therefore it’s important to be aware of the symptoms in order to avoid consequences and live a healthier, more productive life. There are certain clinical research organizations in Michigan conducting clinical trials for this condition.
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