Definition:
Chronic inflammatory disease of the bronchi causing swelling, narrowing of airways, and excessive mucus production, leading to difficulty in breathing. Symptoms include coughing, shortness of breath (SOB), and wheezing.
Classification of Asthma
- Important to distinguish between these two as it affects treatment options (e.g., antihistamines for atopic, antibiotics and immune modulators for non-atopic).
Etiology
- Genetic Factors: Family history of asthma or atopic diseases like eczema or hay fever. Higher levels of IgE are often seen.
- Environmental Factors: Exposure to allergens (pollen, dust, pet dander) or pollutants (smoking, air pollution).
- Other Factors: Infections, especially respiratory infections like pneumonia or sinusitis in childhood, can contribute to the onset of non-atopic asthma.
- Atopic benefits more from allergen avoidance and immunotherapy, while Non-Atopic might require focus on respiratory infection management.
Special Types of Asthma
- Drug-Induced Asthma: Triggered by medications like aspirin, NSAIDs, or beta-blockers (known as aspirin-induced asthma).
- Exercise-Induced Asthma: Common in young individuals, particularly triggered by physical activity in cold or dry air.
- Asthma Provoked by GERD: Acid reflux can irritate the airways and trigger asthma attacks.
The mechanism of aspirin-induced asthma involves the inhibition of cyclooxygenase, leading to a shift towards the production of leukotrienes—powerful bronchoconstrictors.