The Cell Biology Of Asthma
- Abbreviations used in this paper:
Rho-associated coiled-coil containing protein kinase
SAM-pointed domaincontaining Ets-like factor
signal transducer and activator of transcription 6
J Cell Biol
David J. Erle, Dean Sheppard; The cell biology of asthma. J Cell Biol 9 June 2014; 205 : 621631. doi:
The clinical manifestations of asthma are caused by obstruction of the conducting airways of the lung. Two airway cell types are critical for asthma pathogenesis: epithelial cells and smooth muscle cells. Airway epithelial cells, which are the first line of defense against inhaled pathogens and particles, initiate airway inflammation and produce mucus, an important contributor to airway obstruction. The other main cause of airway obstruction is contraction of airway smooth muscle. Complementary experimental approaches involving cultured cells, animal models, and human clinical studies have provided many insights into diverse mechanisms that contribute to airway epithelial and smooth muscle cell pathology in this complex disease.
Reactive Airways Dysfunction Syndrome
Reactive airways dysfunction syndrome is a rapid onset and persistent asthma-like disorder that occurs in people with no history of asthma. It is a form of environmental lung disease caused by a single large exposure to nitrogen oxide or volatile organic compounds . People have symptoms similar to those of asthma, including cough, wheezing, and shortness of breath. Treatment is similar to usual treatment for asthma.
Everyday Treatment For Asthma In Children
The main aims of day-to-day asthma treatment are to:
- keep symptoms under control
- keep lungs as healthy as possible
- stop asthma from interfering with school or play
- help your child enjoy a full and active life.
Your doctor will help you to develop a plan to manage your childs asthma which will include an asthma action plan , and will prescribe the correct medication to help you do so.
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What Medications Are Used For The Treatment Of Asthma Attacks
It causes the tissue inside the airways to swell. As you know, during an asthma attack the airways narrow. What medications are used for the treatment of asthma attacks? The muscles around the airways constrict . During an asthma attack, your breathing measurements on the pef meter will be lower than normal. In asthma, there is a continuous state of hyperreactivity of the bronchi, during which exposure to a wide variety of bronchial irritants will precipitate an asthmatic attack. During an asthma attack, the airways become inflamed. During an asthma attack, the muscles that surround the bronchial tubes constrict, narrowing the air passages and making it extremely difficult to breathe. When they tighten, it makes the inflammation: An asthma attack is when asthma symptoms worsen. .during an asthma attack, the airways also tend to close at abnormally high lung volumes, trapping air behind occluded or narrowed small airways.thus the acute asthmatic will breathe at high lung volumes, his functional residual capacity will be elevated, and he will inspire close to total lung capacity. According to the american academy of allergy, asthma & immunology , these symptoms can. This video follows a young man as he suffers an asthma attack.
An asthma attack is a sudden worsening of asthma symptoms caused by the tightening of muscles around your airways.
An asthma attack starts with exposure to an asthma trigger.
It causes the tissue inside the airways to swell.
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What Exactly Happens During An Asthma Attack
An asthma attack is the common name of an asthma flare or exacerbation. This always starts with exposure to an allergen or trigger. The trigger can be different for every patient.
After the exposure, the airways experience an inflammatory reaction. Theres a release of inflammatory substances and cells of your immune system. This increases the production of mucus in the bronchi and muscle contraction and swelling of the bronchi membranes. The gathering of these three things results in a smaller caliber of the airway.
The consequence is an obstructed airway and impaired airflow. Also, this results in the common respiratory symptoms of every asthma attack, like coughing and wheezing. Additionally, since the airflow is impaired, there is less oxygen that gets to the alveoli. This can affect the oxygenation of other tissues of your body.
What are some common asthma triggers?
Almost anything that can act as an irritant of the airway can trigger an asthma attack. The triggers may vary from patient to patient. If you have asthma, you may have different triggers than another asthma patient. This is entirely normal. In fact, a way to managing asthma is to know your personal triggers and avoid them. Some of the most common triggers are:
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Understanding Asthma Pathophysiology Diagnosis And Management
A chronic inflammatory airway disorder, asthma is marked by airway hyperresponsiveness with recurrent episodes of wheezing, coughing, tightness of the chest, and shortness of breath. Typically, these episodes are associated with airflow obstruction that may be reversed spontaneously or with treatment.
Asthma affects approximately 300 million people around the world. In children, males have a higher asthma risk; in adults, females have a higher prevalence.
Experts believe asthma results from various host factors, environmental factors, or a combination. Host factors include gender, obesity, and genetics. Genetic factors include atopy. Defined as a genetic tendency to develop allergic diseases, such as asthma and allergic rhinitis, atopy commonly is linked to an immunoglobulin E mediated response to allergens.
What Are The Complications Of Asthma
Asthma can result in many complications if left untreated. From a medical point of view, patients with asthma have a higher chance of developing respiratory failure. It can be potentially fatal.
Moreover, a closed airway with excess mucus is the perfect environment for bacteria to grow. This is why asthma patients are very likely to develop pneumonia and other respiratory infections.
In the long term, asthma can cause a remodeling of the airway. This is basically a change in the structure of the airways due to chronic inflammation that results from chronic asthma. This remodeling can lead to loss of lung function, chronic coughing, and thicker airway walls. Also, asthma patients are more likely to need hospitalization to get treatment and oxygen supply. Finally, patients can experience unpleasant side effects from their asthma medications.
From a lifestyle point of view, having asthma can affect the patients life. For adults, asthma is the reason for frequent sick days from work and increased risk of depression. For children, asthma can mean having growth delay and a higher risk for learning disabilities.
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Asthma Management Can Help
A single individual’s asthma does not necessarily remain in the same category permanently. A person with seasonal asthma triggers may find that at a certain time of year for instance, when ragweed pollen is in the air he or she is in a higher severity group than during the rest of the year.
Asthma that starts during childhood also may become less severe as a person grows and his or her airways become wider. For any person with asthma, effective ongoing asthma control can help them move into a less severe category.
The asthma experts at UI Health can help you bring your asthma under control. To request an appointment, please fill out the online form or call 312.996.3300.
Bronchial Tubes Also Prevent Foreign Invaders
While your doctor probably often talks about the overproduction of mucus in asthma, you need some mucus to be healthy. The mucus acts as a sticky pad and tries to keep foreign things that should not be in your lungs out. Not only does the mucus keep the lungs moist, but it acts as a trap keeping out things like dust, bacteria, or viruses that could trigger an asthma attack.
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How Does Asthma Affect The Alveoli
During an asthma episode, the mucus-producing cells within the airway increase their output and mucus plugs the airway. The combination of airway narrowing, mucus plugging, and airway inflammation can block portions of the airway entirely. Air becomes trapped in the alveoli .
Subsequently, question is, how Does asthma affect the lungs? Asthma is a chronic, or long-term, condition that intermittently inflames and narrows the airways in the lungs. The inflammation makes the airways swell. Asthma causes periods of wheezing, chest tightness, shortness of breath, and coughing. Asthma affects people of all ages and often starts during childhood.
Simply so, how Does asthma affect gas exchange in the alveoli?
Asthma, the inflammation in the airways leading to the lungs, can affect breathing as well. Asthma makes it difficult to bring air into the lungs because airways become very narrow when they are inflamed. Less air into the lungs means less gas exchanged.
What Body System Does asthma affect?
Asthma is a chronic disease that affects the airways that carry oxygen in and out of the lungs. If a person has asthma, the inside of these airways is irritated and swollen. Asthma can cause shortness of breath, wheezing, coughing, and tightness in the chest.
What Are Some Of The Main Causes Of Asthma
There is no exact cause to explain this disease. Doctors agree that its a combination of several factors. The main reason for asthma to occur is airway inflammation. This results in increased discharge of mucus, muscle contraction of the bronchi, and swelling of the bronchis inner lining. This is what causes the obstruction of the airway and the symptoms of an asthma attack.
Nevertheless, this latter process starts after exposure to a trigger. Asthma triggers are usually irritants of the airway that can start an inflammatory reaction, resulting in an asthma attack. The link between asthma and allergic conditions is close. Patients with allergies usually develop this condition as another form of manifestation of the allergy.
There is also an important genetic factor to develop this condition. This means that anyone who has a family member with asthma is more likely to develop this condition. For children, the chances of having this disease increase significantly if both parents are asthmatic patients.
In conclusion, allergic and genetic factors are the most important in the development of asthma.
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How The Treatment Goals Are Attained
Unfortunately, there is no magic bullet for asthma. While treatment can control symptoms safely and effectively for most patients most of the time, it is not a simple matter of the doctor writing a prescription and the patient taking the medication. Successful treatment of asthma is likely to require several steps on the part of physician. These include:
- Confirmation of the diagnosis
- Characterization of the asthma with regard to:
- Identification of triggers
- Identification of the components of airway obstruction
The diagnosis of asthma is suspected when a patient has a history of recurrent or chronic shortness of breath, labored breathing, or cough in the absence of any other obvious reason. The diagnosis is confirmed by obtaining evidence that there is airway obstruction that reverses either spontaneously or as a result of treatment with anti-asthmatic measures. The procedures used to make the diagnosis include a careful history, measurement of pulmonary function , and therapeutic trials of medication.
Triggers of asthma, those identifiable factors that commonly worsen symptoms include:
- Viral respiratory infections ;
- Airborne allergens ;
- Inhaled irritants ;
- Cold air
Patients with an intermittent pattern of asthma require only intervention measures.
Why Does Someone Get It
Over 10% of people have some history of asthma. It often runs in families. The heritable nature of asthma is not well understood, however, and geneticists cannot define the precise manner in which it is passed from parents to children. All we can say is that families with asthma are more likely to have children with asthma. Although there appears to be an inherited predisposition to develop asthma, severity varies considerably among asthmatics, even among members in the same family. If asthma is present in both parents, the likelihood of a child having asthma is even greater, but even then not all of the children will have asthma. Even among identical twins, both do not necessarily have asthma, although this is more likely than if they were just siblings or nonidentical twins. This suggests that there is some additional factor that we do not yet fully understand, other than inheritance, that influences the development of asthma.
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Monitoring Asthma At Home
Some people use a handheld peak flow meter to evaluate their breathing and determine when they need intervention, before their symptoms become severe. People who experience frequent, severe asthma attacks should know how to reach help quickly.
Peak expiratory flow can be measured using a small handheld device called a peak flow meter. This test can be used at home to monitor the severity of asthma. Usually, peak flow rates are lowest between 4 AM and 6 AM and highest at 4 PM. However, more than a 30% difference in rates at these times is considered evidence of moderate to severe asthma. People with moderate to severe asthma, particularly those who need daily treatment to control symptoms, often use a peak flow meter to take measurements and compare them to their personal best to help identify signs of worsening asthma or the onset of an asthma attack.
All people with asthma should have a written treatment action plan that was devised in collaboration with their doctor. Such a plan allows them to take control of their own treatment and has been shown to decrease the number of times people need to seek care for asthma in the emergency department.
Asthma Action Plan_0312 Slideshow
An asthma action plan, or management plan, is a written plan developed by healthcare providers for patients with asthma that indicates the patients medications and specific information on dosing and timing, as well as instructions on how to handle worsening asthma or attacks. Anyone caring for a child with asthma should be aware of the asthma action plan, including babysitters, daycare workers, school teachers and camp counselors.
Asthma is a lifelong disease that causes wheezing, breathlessness, chest tightness, and coughing, and can limit a persons quality of life. Between 2001 and 2009, the number of people diagnosed with asthma increased by 4.3 million. The cause of growing asthma rates remains unknown, but patients can control their condition by avoiding asthma triggers and using appropriate medications. Learn more about asthma with this slideshow.
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How Do Your Airways Work When You Have Asthma
When you have asthma, your airways aren’t able to function as well as they should.
- Chest tightness
Asthma causes inflammation, or swelling, in the lungs. It can also cause squeezing, called bronchoconstriction , and extra sensitive or twitchy airways.
When something bothers your airways, you have trouble breathing. This is called an asthma attack or episode. It gets harder to breathe because the tiny muscles around your airways squeeze tightly and they have swelling inside.
Your airways will make more mucus inside your airways, which makes it even harder to breathe. These changes in your airways can cause coughing and wheezing.
There is no cure for asthma. But you can take steps to manage it. If you have asthma, it’s important to see an asthma specialist, like an allergist or pulmonologist, to come up with the right asthma treatment plan. Medicines and avoiding asthma triggers can help reduce swelling and relax tight muscles in your airways.
ASTHMA Care for Adults
How To Reduce Your Risk Of Complications
In general, working with your doctor can help you find the appropriate treatment to control your asthma symptoms and reduce your risk for these complications. And once you find a treatment that works for you, its important to stick with it.
Most people with asthma know the importance of staying on prescribed treatment, Rosenstreich says. Because if they dont, they know theyll see an increase in their symptoms. But your doctor will remind you that symptoms are only the start. These complications are, in most cases, rare and totally avoidable simply by staying with your treatment.
If you have trouble controlling your symptoms despite following your treatment plan, you may have a more severe form of asthma. Let your doctor know about your struggles so he or she can help find a more appropriate treatment.
With additional reporting by Markham Heid.
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Peak Flow Meter_0312 Slideshow
A peak flow meter is used to monitor lung function by measuring the maximum rate at which air is expelled from the lungs. The patient takes a deep breath and breathes out as hard as possible into the mouthpiece. This test can be used to detect asthma and other lung disorders. Patients should know their baseline best breathing measurement. Peak flow readings between 50% and 80% of a baseline reading indicate onset of an asthma attack, whereas readings below 50% indicate an asthma emergency.
What You Need To Know About Your Childs Asthma
There are many things to think about and plan for when your child has asthma. It is important to learn as much as you can about the condition. Your doctor and pharmacist are there to help you. Talk to them about any concerns you may have about your childs asthma. To manage your childs asthma effectively, it is important to know:
- the pattern of their asthma
- their asthma medications what they do and how to help your child take them properly
- what to do if they have an asthma attack know and follow asthma first aid.
Make sure you have an updated written asthma action plan and understand how to use it.
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Evaluating An Asthma Attack
Because people who are having a severe asthma attack commonly have low blood oxygen levels, doctors may check the level of oxygen by using a sensing monitor on a finger or ear . In severe attacks, doctors also need to measure levels of carbon dioxide in the blood, and this test typically requires obtaining a sample of blood from an artery or, occasionally, a vein. However, carbon dioxide levels can sometimes be monitored in the person’s breath using a sensor placed in front of the nose or mouth.
Doctors may also check lung function, usually with a spirometer or with a peak flow meter. Usually, a chest x-ray is needed only when asthma attacks are severe, in order to rule out other serious conditions .
Treatment For Asthma Emergencies In Children
An asthma attack can quickly become an asthma emergency, but if you take quick action, you can reduce the risk of this happening. So, if the symptoms of an asthma attack appear, follow your childs asthma action plan.
If your child is experiencing a severe or life-threatening asthma attack, call triple zero for an ambulance and then start asthma first aid.:
- Sit the child upright.
- Give 4 puffs of reliever medication , taking 4 breaths for each puff. Use a spacer and mask if one is available.
- Wait 4 minutes if the child still cannot breathe normally, give 4 more puffs.
- Continue to give 4 separate puffs of reliever medication, taking 4 breaths for each puff, every 4 minutes until the ambulance arrives.
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How Is Asthma Treated
There’s no cure for asthma, but it can be managed to prevent flare-ups. Asthma treatment involves two important things: avoiding triggers and taking medicine.
There are many ways to avoid triggers. After your child’s triggers are identified, the doctor will work with you to come up with a plan to avoid them.
For example, if pet dander or mold in your home trigger your child’s asthma symptoms, you can make your home asthma-safe by changing the linens often, vacuuming regularly, and keeping the family pet out of your child’s bedroom. If outdoor allergies are a problem, your child should avoid the outdoors on days when pollen counts are high.
If exercise is a trigger, the doctor may prescribe a medicine for your child to take before physical activity to prevent airways from tightening up. Doctors help people with exercise-induced asthma manage physical activity, not avoid it. Exercise can help people stay healthier overall .
Getting a yearly flu shot is also important, as illnesses like the flu can trigger asthma flare-ups.
Most asthma medicines are breathed directly into the lungs , but some are pills or liquids. There are two types of asthma medicines:
Quick-relief medicines act fast to open up tight airways. They can be used as needed during a flare-up. Quick-relief medicines act fast, but their effect doesn’t last long. These kinds of medicines are also called “fast-acting” or “rescue” medicines.
How Bronchial Tubes Are Impacted By Asthma
Asthma affects the bronchial tubes by causing inflammation that can lead to bronchoconstriction and increased mucus production that impairs the flow of air. As a result, the changes lead to symptoms such as:
The treatments for changes in the bronchial tubes are both drugs to provide acute symptom relief and drugs designed to prevent asthma symptoms. Rescue inhalers are designed to provide acute asthma relief by opening up your airways and increasing airflow. These medications are only taken as needed and use more than twice per week indicates poor asthma control. Preventive medications, on the other hand, are taken daily no matter how you are feeling. These medications prevent inflammation and increased mucus production from getting to the point to increase your asthma symptoms.
Asthma usually does not permanently damage the structure of the bronchial tubes, but other diseases can, such as:
- Recurrent infections
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Summary Of The Invention
The invention is a method for treating lung disease and in particular, a method for treating the lung during an acute episode of reversible obstructive pulmonary disease such as an asthma attack. One embodiment of the present invention includes a method for treating asthma comprising the step of transferring energy to an airway wall of an airway in a lung such that a diameter of the airway is increased. The energy may be transferred to the airway wall prior to, during or after an asthma attack. The energy may also be transferred in an amount sufficient to temporarily or permanently increase the effective diameter of the airway. The method may be performed while the airway is open, closed or partially closed.
In another embodiment of the invention, a method for treating asthma in a lung having a constricted airway comprises transferring energy to an airway wall of the constricted airway sufficient to open the airway. The energy transferred may be in an amount sufficient to permanently or temporarily open the constricted airway. The method may be performed to open a wholly constricted airway as well as a partly constricted airway.
In yet another variation of the invention, a combination of the above discussed techniques are carried out such that at one time, energy is applied while the distal portion of the energy delivery device is being moved and at another time, energy is applied when the distal portion of the apparatus is stationary.
Increased Asm Mass In Asthma
Another possible mechanism of increased ASM mass is the migration and differentiation of fibrocytes from bone marrow . Fibrocytes exposed in culture to TGF- acquire characteristics of smooth muscle cells , and the number of circulating fibrocytes in the peripheral blood of individuals with asthma with chronic airflow obstruction correlates with their rate of decline in lung function over time . Therefore, interest has developed in TGF- as a therapeutic target in asthma . Animal models of allergen-induced asthma have shown significant reductions in ASM proliferation following TGF- neutralization or inhibition .
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