Cause of asthma; A must read
Pharm. Somtochukwu
Let’s take a deep look at the cause of asthma. There is no doubt that asthma affects people of all ages, races, and classes.
Asthma is a respiratory disorder, characterized by the narrowing of the airways which causes difficulty in breathing.
Introduction to the cause of asthma
Asthma is a terror to some persons because of the mode of the onset and the disgrace attached to it.
After reading through this article, asthma will lose its terror, and that is the good news we bring to you, understanding the cause of asthma will give you a better insight into the disorder, making the solution crystal clear on your palms.
Types of asthma
Asthma is classified based on the precipitants so the types are usually
- NON ALLERGIC OR INTRINSIC ASTHMA`
- ALLERGIC OR EXTRINSIC ASTHMA
- OCCUPATIONAL ASTHMA
- EXERCISE-INDUCED BRONCHOCONSTRICTION
Allergic or Extrinsic Asthma
As it is always said, that asthma is a multi-factorial disorder, extrinsic asthma is the commonest diagnosis in children.
Over sixty percent of children between the ages of 2-8 diagnose has extrinsic asthma with a family history of allergies.
The Centers for Disease Control (CDC) gave a review that children experience more emergency visits and admissions for asthma than adults.
Allergens considered as precipitants may include Pollen of trees and grasses, weeds, and dust mites, these substances trigger allergic reactions which lead to the narrowing of the airways leading to an asthmatic episode.
Although intrinsic factors like drugs, food additives, and exercise could trigger allergies. Allergies and asthma are related in a broader scope although the cause of asthma or the general mechanism of the cause of asthma will be discussed later in this article.
Non-Allergic Or Intrinsic Asthma
The prevalence of Intrinsic asthma is low when compared with extrinsic asthma.
And it is mostly diagnosed in adults over 30 years of age mostly in females.
This type of asthma is caused by non-allergic factors such as drugs, respiratory infections, Exercise, weather conditions, and food additives.
Obesity had been considered as the most common asthma co-morbidity ranging from mechanical alteration to inflammation of the airways
Occupational Asthma
This type of asthma occurs as a result of exposure to pollen grains in the place of work or as a result of one’s profession like in the case of marine divers.
Occupational asthma is prevalent in some firms like flour mills, baking industries, cosmetic companies, and others.
Frequently asthmatic episodes are mostly observed when one is active in the working place and there is equally a relief when one stays out of work.
Exercise-Induced Bronchoconstriction
It results from rigorous physical activities which bring about a decrease in the extracellular fluid which triggers the heart rate and equally leads to tightening of the airways which is an asthmatic incidence. Although some people don’t classify it as a type of asthma because not everybody with exercise-induced bronchoconstriction has asthma.
Cardinal Symptoms Of Asthma
- Wheezing
- Difficulty breathing
- Coughing, most especially at night, or during exercise
- A feel of Tightness of the thoracic cage
- Shortness of breath brings about gasping for air
- Sleep Apnea
Pathophysiology Or Cause Of Asthma
This is our focal point in this article and understanding this sector will equip you to tackle this disorder professionally and seamlessly, the cause of asthma is quite a complex one, but we have worked tirelessly to make it comprehensible in all stages.
In the pathophysiology of asthma two cardinal features are considered.
Firstly, is the constriction of the bronchus (bronchoconstriction), followed by inflammation of the bronchus (bronchoinflammation).
An ideal airway, {bronchi} is maintained by the autonomic nervous system which is a branch of the central nervous system.
The autonomic nervous system is made of the sympathetic and parasympathetic nervous systems which both function automatically.
The parasympathetic reflex loop initiates smooth muscle contraction when stimulated while the sympathetic nervous system relaxes smooth muscle when stimulated.
The parasympathetic nervous system comprises sensory nerve endings which originate beneath the inner lining of the bronchus.
when an allergen gets into the airway, it stimulates the parasympathetic nervous system which causes the release of acetylcholine through the motor neuron, acetylcholine release brings about the excessive formation of inositol1,4,5-triphosphate {IP3} which triggers bronchoconstriction and bronchospasm.
Bronchoconstriction
This is precipitated by environmental factors such as pollen, the fragrance of some products, and others. When the airway is exposed to such factors, there is excessive production of mucus from the mucus membrane which brings about the difficulty in breathing.
In asthmatic patients, the airways are hypersensitive to these precipitants {type I hypersensitivity} in response to exposure to these precipitants, the bronchi contract into spasm {involuntary muscle contraction} which leads to further tightening or narrowing of the airways which bring about the whistling sound in asthma.
Bronchoinflammation
Here the walls of the bronchi inflame radically and are the foundation behind allergic asthma because it results from immune response to inhaled allergens.
When allergens {dust, pollen, Smoke, and others} find their ways into the inner airway, APCs {antigen-presenting cells} present these allergens to cells of the immune system, most especially the TH0 cells.
In persons without the asthmatic disorder, these allergens are usually checked and ignored but in asthmatic patients when these allergens are presented by APC, to TH0 cells {T-helper 0 cells} there is the transformation of TH0 cells to TH2 cells, which further activate humoral Immune System.
The activation of the humoral immune system triggers the production of antibodies against the inhaled allergen and a memory of the allergen is kept by the antibodies.
when a patient is exposed to some allergen, a humoral response is initiated leading to inflammation of the bronchi which is associated with further thickening of the airways, increased mucus production, and equally bronchospasm.
Prevention Of Asthmatic Attacks
When clever approaches are taken towards asthma one can live comfortably without asthmatic assault. so we bring to you a few tips.
- Always follow your asthma action plan
- Vaccination against influenza and pneumonia is a clever approach
- Always avoid asthma precipitants
- Take your medications as prescribed by physicians
- Always check and monitor your breathing
Treatments/Medications For Asthma
The stimulation of the sympathetic reflex loop initiates the dilation or relaxation of smooth muscles, {bronchi muscles}, most drugs for asthma are usually regarded as sympathomimetic drugs{mimic the action of the sympathetic nervous system}.
Below are some medications for asthma.
- Short-acting bronchodilators like albuterol provide fast relief and can be used in conjunction for exercise-induced symptoms.
- Long-acting bronchodilators like salmeterol and formoterol
- Inhaled steroids budesonide and fluticasone are first-line anti-inflammatory therapy
- Leukotriene modifiers like montelukast and zafirlukast can also serve as anti-inflammatory agents.
- Anticholinergic agents like ipratropium can help decrease sputum production.
- Chromones like cromolyn and nedocromil stabilize mast cells (allergic cells).
- Systemic steroids prednisone and prednisolone are potent anti-inflammatory agents that are routinely used to treat asthma exacerbations but pose numerous unwanted side effects if used repeatedly or chronically.
- Immunotherapy or allergy shots have been shown to decrease medication reliance in allergic asthma.
A final thought on the Cause of Asthma
Asthma severity ranges from the cause, type, and general physiological state of an individual. knowing the precipitants and avoiding them is a clever approach to living better and having your inhaler would help overcome most asthmatic episodes.
always seek medical attention if you feel you are deteriorating in health or the situation gets worse each day.
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Pharm Somtochukwu Oluka P. is a licensed pharmacist with a burning desire to explore his zeal and interest in the field of pharmacy.
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