Asthma (cont.)
The importance of inflammation
Inflammation, or swelling, is a normal response of the body to injury or
infection. The blood flow increases to the affected site and cells rush in and
ward off the offending problem. The healing process has begun. Usually, when the
healing is complete, the inflammation subsides. Sometimes, the healing process
causes scarring. The central issue in asthma, however, is that the inflammation
does not resolve completely on its own. In the short term, this results in
recurrent "attacks" of asthma. In the long term, it may lead to permanent
thickening of the bronchial walls, called airway "remodeling." If this
occurs, the narrowing of the bronchial tubes may become irreversible and poorly
responsive to medications. Therefore, the goals of asthma treatment are: (1) in
the short term, to control airway inflammation in order to reduce the reactivity
of the airways; and (2) in the long term, to prevent airway remodeling.
Allergy assist
The hallmark of managing asthma is the prevention and treatment of airway
inflammation. It is also likely that control of the inflammation will prevent
airway remodeling and thereby prevent permanent loss of lung function.
Various triggers in susceptible individuals result in airway inflammation. Prolonged inflammation induces a state of airway
hyperreactivity, which might progress to airway remodeling unless treated effectively.
Which triggers cause an asthma attack?
Asthma symptoms may be activated or aggravated by many agents. Not all
asthmatics react to the same triggers. Additionally, the effect that each
trigger has on the lungs varies from one individual to another. In general, the
severity of your asthma depends on how many agents activate your symptoms and
how sensitive your lungs are to them. Most of these triggers can also worsen
nasal or eye symptoms.
Triggers fall into two categories:
- allergens ("specific") and
- nonallergens -- mostly irritants (nonspecific).
Once your bronchial tubes (nose and eyes) become inflamed from an allergic
exposure, a re-exposure to the offending allergens will often activate symptoms.
These "reactive" bronchial tubes might also respond to other triggers, such
as exercise, infections, and other irritants. The following is a simple
checklist.
Common Asthma Triggers:
Allergens
- "seasonal" pollens
- year-round dust mites, molds, pets, and insect parts
- foods, such as fish, egg, peanuts, nuts, cow's milk, and soy
- additives, such as sulfites
- work-related agents, such as latex
Allergy fact
About 80% of children and 50% of adults with asthma also have allergies.
Irritants
- respiratory infections, such as those caused by viral "colds," bronchitis,
and sinusitis
- drugs, such as aspirin, other NSAIDs (nonsteroidal antiinflammatory
drugs), and beta blockers (used to treat blood pressure and other heart
conditions)
- tobacco smoke
- outdoor factors, such as smog, weather changes, and diesel fumes
- indoor factors, such as paint, detergents, deodorants, chemicals, and
perfumes
- nighttime
- GERD (gastroesophageal reflux disorder)
- exercise, especially under cold dry conditions
- work-related factors, such as chemicals, dusts, gases, and metals
- emotional factors, such as laughing, crying, yelling, and distress
- hormonal factors, such as in premenstrual syndrome
Next: The many faces of asthma »
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