What is asthma?

Asthma is a long-term inflammatory disease of the airways, also known as bronchi, in the lungs. The name “Asthma” originates from the Greek word for “panting”, and panting is symptomatic for the disease. The characteristic shortness of breath is a result of a narrowing of the airways and airflow obstruction in the lungs. Asthma may occur at any age, but in roughly half the cases it occurs before the age of 10. In one third of the cases, it occurs before the age of 40. In the UK, roughly 5 million people are diagnosed with asthma, and it is estimated that roughly half of these are inadequately treated or untreated, which might lead to complications such as pneumonia, reduced lung function and decreased quality of life.

What are the symptoms of asthma?

The symptoms of asthma include:

  • Coughing: Either dry or chesty. The coughing can occur at night or in connection with laughing, crying or physical exertion.
  • Shortness of breath or breathlessness to varying degrees. Severe symptoms include rapid breathing or breathing difficulties when at rest, and difficulties speaking.
  • Wheezing or a whistling sound when breathing
  • A tight chest and the feeling that a band is tightening around it

Even if you only experience one of the symptoms above, you might still be experiencing asthma. It is especially important to react if you experience coughing, shortness of breath or breathlessness at night. Consult your GP if there is any suspicion that you might have asthma.

What are the causes of asthma?

The disease is often hereditary, and around 100 genes, which are believed to affect the development of the disease, have been identified. Other risk factors include exposure to allergens, air pollution, smoking, second hand smoking and repeated bronchial infections. The risk of developing asthma is increased if you are exposed to certain allergens as a child. In addition, it is believed that the risk of developing asthma and allergies is greater if you spend much time in a very clean, sterile environment, as the body’s immune system will not get used to handling foreign organisms. This theory is called “The hygiene hypothesis”.

The inflammation of the bronchi occurs because the immune system overreacts to specific antigens like allergens or harmful substances in tobacco smoke.

The immune system in people who do not suffer from asthma helps kill antigens and the harmful effects these might have. For patients with asthma, the immune response will be so long-lasting and powerful, that it will do more harm than good. The pathological immune response is the result of an excess release and activation of various cytokines (cytokines are small proteins important in cell signalling). This leads to tissue damage, abnormal contractions of the smooth muscle cells of the bronchi as well as phlegm secretion in the air ways. Altogether, this leads to a narrowing of the breathing tubes and the airflow to and from the lungs is obstructed.

What are the treatments for asthma?

The purpose of treating asthma is to ensure that the patient is able to live an active and normal life despite of the disease. The treatment primarily consists of inhaler medication, which affects the bronchi directly, thereby minimising the risk of side effects.

The medication must be taken daily and it is primarily preventive. However, it should be taken alongside reliever medication in acute situations. The preventive medication consists of adrenocortical hormone, which decreases the immune response and ease the inflammation of the lungs. The reliever medication used for asthma attacks is more powerful and works by expanding the airways, as it relaxes the small muscles surrounding the airways. This type of medication is fast acting, but it only works for a brief period of time.

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