Non-Allergic and Allergic Asthma

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Category: Immunodeficiency Articles Published on Monday, 14 July 2008 Written by Yong Tsai, MD
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Asthma, a common chronic childhood disease, affects 17 million people in the United States .  And unfortunately the incidence of asthma is dramatically on the rise, particularly in highly developed parts of the word.

From the Greek word for panting or breathlessness, asthma is characterized as inflammation of the airway passages.  When inflammation occurs, the airway lining passage swells and produces mucus. Bands of muscle begin to contract generating further narrowing the airway with increased mucus and fluid (congestion). At this point, patients experience chest tightness and shortness of breath, coughing, wheezing, and difficulty breathing.

Asthma is frequently caused by allergies (allergic asthma) and usually emerges during childhood, affecting more boys than girls.  About 90% of children under the age of sixteen have asthma of an allergic type.  Often, childhood asthma may be misdiagnosed as recurrent bronchitis or pneumonia because of the persistent coughing and wheezing.

Tree, grass, and weed pollen, dust mites, animal dander and even foods are known as common triggers of allergic asthma. When these allergens interact with our IgE immunoglobulin, mast cells and basophiles, a release of chemical mediators is triggered, such as histamine, prostaglandins, and leukotriens to name a few, that produce inflammation of the airway passage lining.  Having a family history of allergies and experiencing symptoms during particular seasons are major factors in diagnosing allergic asthma.

While less common, adult -onset, affects more women than men and seems to also be caused by non-allergic irritants such as smoke, perfumes, chemical fumes and air pollutants.  Furthermore, upper respiratory tract infections, such as the common cold, flu or sinusitis, GERD, the use of non-steroidal anti-inflammatory drugs (NSAIDs) and even exercise may also trigger for some people.

Because asthma is a chronic physical condition, especially in families with a history of allergies, knowing your triggers and taking a pro-active stand can make life much simpler.  Even though your asthma symptoms may change in severity from time to time and even completely disappear for a number of years, the underlying inflammation usually persists and given the right circumstances, asthma can return at any time.

The first step in treating allergic asthma is to avoid the offending allergens we have discussed in the previous column. Next, decreasing the body's production of specific IgE with the help of immunotherapy (allergy shots) is another alternative.  Most patients, however, can feel relief with a bronchodilator medication to relieve bronchospasm and inhaled corticosteroids and leukotriens blockers to decrease inflammation, which we will discuss in detail the next time.

If asthma is treated early and correctly, airway damage can be minimized, episodes can be well controlled, and patients can lead happy and active lives.

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