Your Immune System And Asthma: What To Know
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Researchers now understand asthma is a disease associated with chronic underlying airway inflammation. And this inflammation is caused by an abnormal immune response. Considering this truth, I thought it would be neat to delve into a simple question: What is the immune system anyway? Heres what to know.
Immune Suppression Is A Side Effect Of Inhaled Steroids
Response from John Bottrell, RRT
It’s important to understand that asthma is a syndrome associated with increased airway inflammation. A main feature of this inflammation are immune cells and the chemicals they release . Inhaled corticosteroids greatly diminish the supply and the effects of these immune cells and chemicals.
The benefit here is a reduction in airway inflammation, making your airways less sensitive to asthma triggers. Asthma attacks are less likely to occur and are less severe and easier to control when they do occur. So, yes, inhaled corticosteroids do suppress the immune system — but only in your lungs to help you control your asthma.
Sometimes, especially with higher doses of inhaled steroids, a small amount of the medicine can be absorbed into your system. When this happens, it can mildly suppress your immune system throughout your entire body. In this case, you may notice some mild side effects such as bruises that don’t seem to go away. However, studies seem to show that rinsing your mouth and throat with water, and then spitting it out , greatly reduces your risk for any systemic side effects to inhaled corticosteroids.
What Can Go Wrong With The Immune System
Sometimes a person may have an immune response even though there is no real threat. This can lead to problems such as allergies, asthma, and autoimmune diseases. If you have an autoimmune disease, your immune system attacks healthy cells in your body by mistake.
Other immune system problems happen when your immune system does not work correctly. These problems include immunodeficiency diseases. If you have an immunodeficiency disease, you get sick more often. Your infections may last longer and can be more serious and harder to treat. They are often genetic disorders.
There are other diseases that can affect your immune system. For example, HIV is a virus that harms your immune system by destroying your white blood cells. If HIV is not treated, it can lead to AIDS . People with AIDS have badly damaged immune systems. They get an increasing number of severe illnesses.
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Individuals With Asthma Suffer More Infections And Should Be Under Greater Medical Supervision Says Scientist Behind New Study
Individuals with asthma do not only suffer from problems with their airways and lungs. They also suffer from a greater number of infections elsewhere in the body, shows new research.
The risk of infections is almost as high as that observed in diabetics.
Weve known for many years that individuals with asthma have a higher risk of lung infections than others. But its entirely new that this is also true for infections outside of the lungs, says lead-author Jens Helby Petersen, a doctor at Herlev and Gentofte Hospital, Denmark.
The results are published in the Journal of Internal Medicine.
Read More: Antibiotics are effective at treating asthma
Hay fever and eczema do not increase the risk
The study is based on 23 years worth of data on 105,519 people obtained from two large Danish population registers: the Copenhagen City Heart Study, and the Copenhagen General Population Study.
Helby and colleagues divided the participants into four groups according to whether they suffered from asthma, hay fever, eczema, or none of these.
They focussed on young, non-smokers to ensure that the participants did in fact have asthma and were not misdiagnosed with chronic obstructive pulmonary disease , which can cause similar symptoms.
They then calculated the infection rate of each group and the risk of an individual within that group of contracting an infection.
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Does asthma weaken the immune system?
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What Should I Do Until I Get The Vaccine
While you wait to schedule your vaccine appointment, follow all guidance to protect yourself against COVID-19. This includes:
- Keep at least 6 feet away from others and avoid crowds
- Wash hands often with soap and water or use hand sanitizer with at least 60% alcohol
If you have asthma, keep it under control by following your Asthma Action Planand taking your medications as prescribed.
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Proper Inhaler Technique Can Minimize Side Effects
Side effects of using a steroid inhaler can be prevented by using proper technique and precautions. When breathed in, some steroid medicine remains in the mouth and can be swallowed into the stomach and from there absorbed into the bloodstream. You can minimize any effect from steroids left behind in your mouth in two ways.
First, use a spacer tube with your steroid spray . Medicine that would otherwise land on your tongue and mouth stays in the spacer chamber. The part of the spray that passes through the spacer also tends to pass through your mouth and proceed down onto the bronchial tubes. Second, gargle and rinse your mouth with water after inhaling the steroid spray. Rinsing removes any medicine residue from your mouth. The portion of the medicine that helps your asthma remains undisturbed on your bronchial tubes.
General Precautions For People With Respiratory Conditions
General tips for those with chronic respiratory illnesses such as asthma, chronic obstructive pulmonary disease , idiopathic pulmonary fibrosis, and cystic fibrosis include the following:
- Take your medication as prescribed and manage your symptoms as well as you can.
- Get the flu shot. If you have flu symptoms call your doctor. There are treatments for the flu. However, a flu shot will not protect you against COVID-19.
- Get the pneumococcal vaccine if recommended by your provider. This will also not protect you against COVID-19, though.
- If you smoke, theres never been a better time to stop. Smoking will increase your risk of severe illness and death from COVID-19.
Also Check: How To Make A Homemade Inhaler For Asthma
Some Are Still At The Front Of The Queue
It is important to note that some asthmatics are still considered clinically vulnerable, including those with severe asthma, and those who suffer frequent asthma attacks or are regularly hospitalised. These people are a higher priority for vaccination.
In a way it is good news for asthmatics: the evidence so far indicates that they are no more likely to suffer from severe COVID than people without asthma. Some studies have even shown that asthmatics have a slightly reduced chance of dying from COVID.
Can You Get Sick With Covid
Yes, people can still catch the virus after getting vaccinated. CDC is calling these vaccine breakthrough cases. However, most people who do get COVID-19 post-vaccination develop mild symptoms and are less likely to get hospitalized or die from the virus.
Remember, no vaccine is 100% effective. In clinical trials, the Pfizer/BioNTech vaccine was shown to be 95% effective in preventing symptomatic illness. The Moderna vaccine was shown to be 94.5% effective in preventing symptomatic illness. The Johnson & Johnson vaccine was 66% effective in preventing moderate to severe COVID-19, and 85% effective in preventing severe or critical disease.
Also Check: How To Prevent Asthma Attacks
Mayo Research Examines How Asthma Affects Immune System Increasing Risk For Nonrespiratory Conditions
Young Juhn, M.D. , focuses his research on determining how asthma affects the immune system specifically, the extent to which asthma epidemiology affects the risk and severity of communicable and noncommunicable diseases. Asthma patients have a much higher risk of asthma-associated comorbidity including pneumococcal diseases, otitis media, community-acquired pneumonia, Streptococcus pyogenes upper respiratory infections, influenza, breakthrough chickenpox and pertussis, according to Dr. Juhns research.
This makes sense because these conditions are all airway infections, and asthma has an altered airway architecture including epithelial innate immune dysfunctions, says Dr. Juhn, director of the Asthma Epidemiology Research Unit at Mayo Clinic and a consultant in the Department of Pediatric and Adolescent Medicine. But we wanted to learn whether asthma patients susceptibility also applied to nonrespiratory conditions including systemic inflammatory and autoimmune diseases.
What It Means To Be Immunocompromised
As any new mom would, Erin Anthony worried about germs before the coronavirus outbreak.
Now, the 21-year-old mother of 6-month-old twin boys said she’s “absolutely terrified” of how fast the respiratory virus can spread.
One of Anthony’s sons is in a Dallas facility receiving treatment for multiple conditions, including tracheomalacia, which causes his airway to narrow or collapse while breathing. He breathes through a tracheostomy tube in his throat that connects to his windpipe instead of through his nose and mouth.
It classifies him as “immunocompromised,” a group of people the Centers for Disease Control deems the most vulnerable to coronavirus.
“Usually a normal person that doesn’t have a has a natural filter in their nose so you can filter out the toxins or germs naturally,” Anthony said. “With a , it’s completely bypassed and you don’t have that natural filter, so your lungs are way more susceptible to having infections.”
Since cases appeared in Texas, the Dallas facility where Anthony’s son is being treated has limited visits to caregivers. For him, that means only his parents. The News is not identifying her son or the facility out of concerns for his safety and privacy.
What does “immunocompromised” mean?
Individuals who are immunocompromised have weakened immune systems that are less equipped to fight off infections, said Archana Narayan, an allergist and immunologist at North Texas Allergy and Asthma Associates.
What are immunosuppressants?
Explore further
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Receptors Of Innate Immunity
Many microbes interact with the host through receptors that identify a specific pathogen or microbe-derived molecules. Microbes may limit the development of the allergic adaptive immune response through interaction with a group of these innate immune receptors, including receptors termed Toll-like receptors , early in life. Thus, the innate immune system appears to play a critical role in determining the phenotype of the adaptive immune response.
Toll-like receptors , their ligands, and cellular location. TLR1, 2, 4, 5, and 6 are located on the plasma membrane, while TLR3, 7, 8, and 9 are located in intracellular compartments such as endosomes. Each TLR recognizes a discrete set of ligands and can form homo- or heterodimers, thus increasing the number of ligands recognized. Each TLR has a ligand-binding domain containing leucine-rich repeats. The cytoplasmic portion of the receptor contains a TIR domain that lacks signaling capability, but binds adaptor proteins when ligand is bound. dsRNA = double-stranded RNA LPS = lippolysaccharide ssRNA = single-stranded RNA TIR = Toll-like and interleukin 1 receptor.
Medications That Weaken Your Immune System And Fungal Infections
Overall, most serious fungal infections are rare, but they do happen. They are most common among people with weak immune systems. People with certain health conditions may need to take medications with side effects that can weaken your immune system and put you at risk for fungal infections.
Specifically, corticosteroids and TNF inhibitors are two types of medications that can increase your chances of getting a fungal infection.1
- Corticosteroids are medications that treat conditions including arthritis, asthma, allergic reactions, and autoimmune diseases such as lupus, sarcoidosis, or inflammatory bowel disease.
- TNF inhibitors are medications that treat autoimmune diseases such as rheumatoid arthritis, psoriasis, and inflammatory bowel disease.
Some fungal infections can be serious, such as:
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Medical History And Physical Exam
Your doctor will ask about your risk factors for asthma and your symptoms. They may ask also about any known allergies. This includes how often symptoms occur, what seems to trigger your symptoms, when or where symptoms occur, and if your symptoms wake you up at night.
During the physical exam, your doctor may:
- Listen to your breathing and look for symptoms of asthma
- Look for allergic skin conditions, such as eczema
Expert Commentary & Five
The role of vitamin D in the pathogenesis of immune-mediated diseases such as asthma is only beginning to be understood. Several ongoing or planned human clinical trials are aimed at clarifying this link in the next 5 years. These include both prevention trials, such as one by our group of vitamin D supplementation in pregnant women for the prevention of allergy and asthma in their children , as well as treatment in patients with known severe or steroid-resistant asthma . In addition, studies of vitamin D supplementation in other disease states including TB, multiple sclerosis, lupus and cancer, along with ancillary laboratory investigations, for example of Treg cell function, will aid in our understanding of the role of vitamin D in the modulation of the immune system and its effects on disease. The elucidation of the precise roles of vitamin D in the immune system and in the pathogenesis of multiple diseases has the potential to have profound effects on our ability to prevent and treat these disorders.
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All Medications Have Side Effects
Response from Leon Lebowitz, RRT
It should be noted that all medications come with a veritable laundry list of side effects that may be experienced by some patients using them. Inhalers are no exception. However, the systemic absorption of aerosolized steroids is considered to be minimal. This means that only minuscule amounts of the aerosolized steroid medication are getting into the bloodstream.
For aerosols, less medication is needed since the aerosol is delivered directly to the lung specifically. As an example, the dose of inhaled steroids is measured in micrograms as compared to milligrams , which is the unit of measure for oral steroids. A microgram is one thousand times smaller than a milligram.
Important Information About Covid
From the American College of Allergy, Asthma and Immunology
ARLINGTON HEIGHTS, Ill. The recent pandemic outbreak of COVID-19 is creating concern and uncertainty for many people, especially those who suffer from asthma. The elderly, and anyone with severe asthma, immunodeficiency or other chronic conditions where the immune system may be compromised, are the most susceptible to viral infections in general and must take precautions against COVID-19.
As allergists, we advise all our patients, especially those with asthma, to remain on their medications. Its important that your asthma be well controlled, especially now. None of the asthma medications, including inhaled corticosteroids and biologics, have been shown to increase the risk of getting COVID-19. Also, if you become infected with COVID-19, there is no information that being on any of the asthma medications will make it worse. So please stay on all your medications. Contact your allergist if you have any questions, if you find youre having trouble breathing or your asthma symptoms are becoming more severe.
To date, 80% of cases of COVID-19 are mild and limited in time. Symptoms include fever, cough and shortness of breath. For now, we are advising those with asthma or who may have immunodeficiency to keep up your treatments. It is important that nebulizers are used and cleaned properly. The most important thing is for your asthma to remain well controlled so you can stay healthy.
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Processed And Charred Meats
Like fried foods, processed and charred meats are high in AGEs.
For example, a study that analyzed the AGE content of 549 foods found that fried bacon, broiled hot dogs, roasted skin-on chicken thighs, and grilled steak had the highest AGE contents .
Processed meats are also high in saturated fat. Some research suggests that diets high in saturated fats and low in unsaturated fats may contribute to immune system dysfunction (
Summary
Diets high in processed meat and meats cooked at high temperatures have been linked to increased disease risk and may harm your immune system.
Don’t Try This At Home
One of the main biologics used in allergy practices is omalizumab, an anti-IgE antibody used to treat severe, persistent asthma and chronic urticaria, explained Sanjiv Sur, MD, from the Baylor College of Medicine in Houston.
It is administered subcutaneously and, because it comes with a risk for anaphylaxis, cannot be administered at home, he warned, adding that patients should be evaluated on an individual basis assess to its riskbenefit ratio.
In this time of crisis, some “patients can be switched to oral medicines to manage their urticaria so that they need not be exposed to the risk of coming to the hospital or clinic to receive their injection,” said Sur. However, if a switch is not possible, patients “should continue to receive their injection to prevent losing control of their asthma.”
Similarly, patients who receive biologics like subcutaneous mepolizumab and intravenous gamma globulin, which must be administered in an infusion center or doctor’s office because of the risk for severe adverse effects, should continue to receive them for asthma control, he said.
But there are asthma-focused biologics that can be used at home.
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Foods That Contain Certain Additives
Many food items, especially ultra-processed foods, contain additives to improve shelf life, texture, and taste. Some of these may negatively affect your immune response.
For example, some emulsifiers, which are added to processed foods to improve texture and shelf life, can alter gut bacteria, harm your gut lining, and induce inflammation, all of which can cause immune dysfunction .
Carboxymethylcellulose and polysorbate-80 are commonly used emulsifiers that have been linked to immune dysfunction in rodent studies (
50 ).
Choosing nutritious, high fiber carb sources like starchy vegetables, oats, fruit, and legumes over refined carbs is smart to support immune health.
Summary
A diet high in refined carbs may adversely affect your immune system. Choosing more nutritious carb sources like fruits and starchy vegetables is a better choice for your overall health.