Increased eosinophil granulocyteEosinophils are white blood cells that are responsible for combating infection by parasites in the body. These cells, transparent in vivo appear brick-red when stained by the Romanowsky method. The red colour is visible as small granules within the cell.s
MucusMucus is a slippery secretion of the lining of various membranes in the body ( mucous membranes). Mucus aids in the protection of the lungs by trapping foreign particles that enter the nose during normal breathing. Additionally, it prevents tissues from d plugs
Remodelling (distortion) of the airway
1.1 Pathogenesis
The fundamental problem seems to be immunological: young children in the early stages of asthma show signs of excessive inflammation in their airways.
EpidemiologyEpidemiology is the study of the demographics of disease processes, including the study of epidemics and other diseases that are common enough to allow statistical tools to be applied. So, besides contagious diseases, it also focuses on diabetes, coronary gives clues to the pathogenesisPathogenesis is the mechanism by which a certain etiological factor causes disease pathos disease, genesis development). Some forms of pathogenesis are: Inflammation Malignancy Tissue breakdown In most diseases, there are multiple pathogenetical processes: the incidence of asthma seems to be increasing worldwide; asthma is more common in more affluent countries, and more common in higher socioeconomic groups within countries.
One theory is that it is a disease of hygiene. In nature, babies are exposed to bacteria soon after birth, "switching on" the Th1 lymphocyte cells of the immune system which deal with bacterial infection. If this stimulus is insufficient (as, perhaps, in modern clean environments) then asthma and other allergic diseases may develop. This "Hygiene Hypothesis" may explain the increase in asthma in affluent populations.
Related to the above is another theory regarding the part of our immune system which helps protect us against parasiteA parasite is an organism that lives in or on the living tissue of a host organism at the expense of it. The biological interaction between the host and the parasite is called parasitism. Parasitism is a type of symbiosis, by one definition, although anots, such as tapeworms. The Th2 lymphocytes and eosinophil cells which protect us against worms are the same cells responsible for the allergic reaction. In the Western world these parasites are now rarely encountered but the immune response remains and is triggered in some individuals by certain allergens.
A third theory blames the rise on asthma on air pollutionNew Mexico releases sulfur dioxide and particulate matter into the air. Air pollution is a broad term applied to all chemical and biological agents that modify the natural characteristics of the atmosphere. Some definitions also consider physical perturba. While it is well known that substantial exposures to certain industrial chemicals can cause acute episodes of asthma, it has not been proven that the same is responsible for the development of asthma. In Western Europe, most atmospheric pollutants have fallen significantly in the last forty years while the prevalence of asthma has risen.
Typical triggers include:
inhaled allergens such as house dust mite, pollen, mould spores, pet epithelials
The cardinal symptom of asthma is wheezing, indicating airway obstruction. Cough, sometimes with clear sputum may be present. Typically the symptoms are very variable, often with rapid onset, and associated with the triggers listed above. Symptoms are often worse during the night or on waking. Increasing airway obstruction will cause shortness of breath. Asthma sometimes correlates with acid indigestion, especially amongst older patients.
3 Signs
"Signs" (what a physician finds on examination) are wheeze, rapid breathing, expiratory phase of breathing longer than inspiratory, in drawing of tissues between ribs and above sternum & clavicles, over inflation of the chest and rhonchi (wheezy noises heard with a stethoscope). In severe attacks the asthma sufferer may be cyanosed (blue), may have chest pain and can lose consciousness. Between attacks a person with asthma may show no signs at all.
4 Diagnosis
In most cases the physician can make the diagnosis on the basis of typical symptoms and signs. The typical rapid changes in airway obstruction can be demonstrated by a fall in pulmonary function tests spontaneously, after exercise or inhalation of histamine or metacholine ,and subsequent improvement with an inhaled bronchodilator medication. Many people with asthma have allergies; positive allergy tests support a diagnosis of asthma and may help in identifying avoidable triggers. Other tests (for example chest x-ray) may be required to exclude other lung disease.
5 Treatment
5.1 Symptomatic
Episodes of wheeze and shortness of breath generally respond to inhaled bronchodilators which work by relaxing the smooth muscle in the walls of the bronchi (airways). More severe episodes may need short courses of oral steroids which suppress inflammation and reduce the swelling of the lining of the airway.
Oxygen to alleviate the hypoxia (but not the asthma per se) that is the result of extreme asthma attacks.
If Acid indigestion (GERD) is part of the attack, it is necessary to treat it as well or it will restart the inflammatory process.
5.2 Preventive
Triggers such as pets and aspirin should be identified and avoided. People with asthma who are having symptoms most days will usually benefit from regular preventive medication. The most effective preventive medication are the inhaled steroids.