Home Remedies For Asthma
During an asthma attack, you should seek emergency medical advice as it can be life-threatening. You can make changes in diet and lifestyle in between to improve respiratory health and reduce the frequency and intensity of attacks.;
Dos:
- Take easily digestible, warm, and fresh foods.;
- Include old rice, green gram, horse gram, barley, snake gourd, spices , and honey.;
- Drink lukewarm water.;
- Do Pranayama and Yoga daily.;
Donts:
Asthma Prevalence In Adults And Children
Asthma prevalence seems to be still increasing as suggested by Borna et al., who investigated its change between 2008 and 2016 in Sweden. The authors observed a significant rise of reported frequencies of ever asthma, physician-diagnosed asthma, use of asthma medication, and current asthma, especially in young adults aged 16-25;years. At the same time, an increase in the prevalence of respiratory symptoms during the same period was reported, suggesting the possibility that actually, asthma is underdiagnosed. The potential risk factors for asthma remained the same during the study period.
Recent studies assessed the prevalence of asthma in preschoolers and elementary school children according to Global Initiative for Asthma definition. While no significant difference between rural and urban children was observed, Branco et al found an association with previously identified risk factors for asthma development, including parental asthma and antibiotics in the first year of life. Liu et al investigated the link between maternal hypothyroidism in the perinatal period and childhood asthma risk, in a population-based cohort study using Danish national registers. A higher incidence of asthma was found compared to children born to mothers with no thyroid dysfunction. The risk was even higher if the mothers did not receive thyroid hormone treatment during pregnancy.
How Is Bronchial Thermoplasty Performed
A full course of bronchial thermoplasty treatment includes three separate bronchoscopic procedures: one for the each lower lobe of the lung and another for both upper lobes. Each outpatient procedure is performed approximately at least three weeks apart.
Under sedation, a catheter inside a bronchoscopea thin, flexible tube-like instrument introduced through the patients nose or mouth, and into their lungsdelivers thermal energy into the airways. The patient is monitored after the procedure, and usually, returns home that day or early the next day.
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Overview Of Severe Refractory Asthma Candidates For Bronchial Thermoplasty
Asthma is a chronic inflammatory condition of the airways characterized by episodic symptoms of breathlessness, cough, and wheezing. Approximately 7% of the general population are affected with this chronic condition.7 In most cases, individuals with asthma are able to control their symptoms with proper adherence to anti-inflammatory therapies and avoidance of triggers. However, the burden of hospitalizations for asthma remains high, with more than 497,000 hospitalizations annually.7,8 The latest guidelines from the National Asthma Education and Prevention Program emphasized the importance of assessing asthma severity and control, including impairment and risk .
To address the challenges in properly identifying and managing the approximately 5% to 10% of patients who have severe refractory asthma, the American Thoracic Society hosted a workshop that helped to characterize this condition.9 Major characteristics of individuals with severe refractory asthma were defined as those who are adherent to and require treatment with continuous or near continuous oral corticosteroids or need high-dose inhaled corticosteroids. In addition, two minor criteria are needed.10
Future Developments In The Management Of Asthma
It is likely that new therapies will become available over the next 510 years. Some of the more promising agents are discussed below. We also feel that there will be increasing interest in the heterogeneous nature of asthma in the future, specifically the heterogeneity of treatment response. Identification of factors predicting a response to treatment will enable therapy to be targeted, may improve outcomes and result in more rational, economical use of treatment. This is likely to be particularly important with the introduction of novel agents which are likely to be expensive, effective against only specific components of a complex inflammatory cascade, and therefore best reserved for subgroups of patients most likely to respond. New developments in the pharmacogenetics of asthma are likely to play a key role in this area.
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Challenges In Asthma Management During Covid
Data are still unclear as the COVID-19 population included in the studies is skewed toward older and hospitalized patients with predisposing comorbidities which are strong confounders., Additionally, early clinical reports regarding asthma prevalence among COVID-19 cases often vary in terms of patients severity including those undergoing home quarantine, hospitalized,, or referred to intensive care units and requiring mechanical ventilation. As gender, smoking status, ethnicity, lifestyle, genetic background, and asthma phenotype can influence COVID-19 outcomes, these factors should be carefully investigated., Age seems especially significant, as childhood and adolescent asthma do not seem to be a hazard for COVID-19. This may be related to reduced prevalence of comorbidities, lack of smoking, or boosted immune system due to recent vaccinations.
Figure 4
How Is Asthma Treated
You can control your asthma and avoid an attack by taking your medicine exactly as your doctor or other medical professional tells you to do and by avoiding things that can cause an attack.
Not everyone with asthma takes the same medicine. Some medicines can be inhaled, or breathed in, and some can be taken as a pill. Asthma medicines come in two typesquick relief and long-term control. Quick-relief medicines control the symptoms of an asthma attack. If you need to use your quick-relief medicines more and more, you should visit your doctor or other medical professional to see if you need a different medicine. Long-term control medicines help you have fewer and milder attacks, but they dont help you if youre having an asthma attack.
Asthma medicines can have side effects, but most side effects are mild and soon go away. Ask your doctor or other medical professional about the side effects of your medicines.
The important thing to remember is that you can control your asthma. With your doctors or other medical professionals help, make your own asthma action plan so that you know what to do based on your own symptoms. Decide who should have a copy of your plan and where he or she should keep it.
You can learn more about asthma action plans pdf iconexternal icon;from the National Heart, Lung, and Blood Institute. Take your long-term control medicine even when you dont have symptoms.
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Recent Advances In The Pharmacogenetics Of Asthma
Pharmacogenetics, the study of how genetic differences influence the variability of individual patient responses to drugs, aims to distinguish responders from non-responders and thus lead to rationalised drug therapy. The clinical heterogeneity of asthma has lead to increasing interest in the study of the genetic variability of this disease. There has been particular interest in the pharmacogenetics of 2-agonists and modifiers of the cysteinyl-leukotriene pathway.
2-Agonist pharmacogenetics
The cell surface 2-adrenergic receptor, via which 2-agonists exert their effects, contains a number of genetic variants. Single nucleotide polymorphisms resulting in amino acid substitutions at positions 16 and 27 of the receptor and at position 19 of its upstream peptide are particularly common in white populations and are related to each other. The role of these genetic polymorphisms in 2-agonist treatment response remains unclear, however. Some studies, for example, have suggested that the 2-adrenergic receptor position 16 genotype is associated with the response to 2-agonist treatment with Gly16 homozygotes having diminished and Arg16 homozygotes exaggerated treatment responses. Other studies, however have failed to demonstrate such an association. It is possible that combinations of different alleles rather than single nucleotide polymorphisms are important in determining treatment responses.
Leukotriene pharmacogenetics
Holistic Approaches To Living With Asthma
All you want to do is breathe deeply and fully. You want to fill your lungs with oxygen and feel satisfied. You want to do it rhythmically and naturally, without gasping for air, without fear or panic. For 7% of the U.S population the natural act of breathing often feels impossible. These are the people with asthma.
Many people describe having an asthma attack as if they are trying to breathe through water. For some, it feels an elephant sitting on their chest. Even a person who has lived with asthma for a long time can have varying symptoms depending on their age and what triggers an episode. This means treating asthma requires an individualized approach, exactly what a skilled holistic physician skilled can provide and help you find long-lasting healing approaches to living with asthma. ;
Among the 25 million people in the U.S. who have asthma, it occurs most frequently in children under age 10. Its not just young children who are afflicted. Seven million children age 10-18 and millions of adults also have asthma. Worldwide, it affects adults into their 80s, making asthma a chronic disease that affects people throughout the lifespan.
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How Do Eosinophilic Asthma Treatment Options Work
All of the aforementioned biologic therapies work similarly but slightly differently.
Benralizumab is a humanized monoclonal antibody. It blocks the action of interleukin-5 , which is a protein that works with the immune system. According to the American Partnership for Eosinophilic Disorders, It is approved for use in the U.S. for the add-on maintenance treatment of patients with severe asthma aged 12 and older with an eosinophilic phenotype of asthma. It is used in combination with other asthma medications.
Mepolizumab is also a humanized monoclonal antibody; it recognizes and also blocks the action of IL-5. This biologic can be used for those with EA over the age of 12 and is used in conjunction with other asthma medications.
Reslizumab is an anti-IL-5 monoclonal antibody, also blocking the action of IL-5.
Another biologic therapy that is FDA-approved to treat asthma in general, as opposed to EA, is omalizumab. Omalizumab is a monoclonal antibody that directs its action against the allergy antibody IgE; this can result in less allergy activity, thus reducing asthma symptoms.
Another type of biologic treatment that is used to treat moderate-to-severe eczema is showing promise for the treatment of asthma. Dupilumab is a monoclonal antibody that binds to the protein interleukin-4 receptor alpha subunit ]; this action appears to reduce inflammation.
Why?
- Chronic sinus infections
- Aspirin-exacerbated respiratory disease
Environmental Risk Factors For The Development Of Asthma
Many environmental factors can affect the risk of developing asthma. The American Academy of Allergy Asthma and Immunology and European Academy of Allergy and Clinical Immunology have discussed emerging concepts and challenges in implementing the exposome paradigm and its application in allergic diseases and asthma. The complex network of exposome, genome, transcriptome, proteome, epigenome, and metabolome in driving the disease phenotype and endotype is described.
Air quality has an influence on asthma symptoms and on triggering asthma attacks. Kim et al. correlated measurements of air pollutants around patients houses, including particulate matter , with asthma status and with the frequency of innate immune cells in induced sputum. A significant positive correlation between the amount of PM with a diameter 10;µm and asthma control was reported accompanied by an increased frequency of ILC2s in induced sputum.
Figure 1
Artemisia;pollen allergy is a major cause of asthma in Northern China. Gao et al observed that the frequency of sensitization and the IgE levels related to the four main allergens were significantly lower in subjects from the south of China compared to those from the north, who were more likely to have allergic asthma. The authors also reported that the cosensitization to at least three of the most frequent allergens results in a higher risk of allergic asthma.
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Will Medicine Help Me Sleep Better
Yes, if you have nighttime asthma symptoms. Many people wake up with asthma symptoms such as coughing or wheezing. You can control nighttime symptoms by taking asthma medicines as directed by your doctor.;
Removing triggers where you sleep may help you sleep better. Many people are allergic to dust mites and mold found in bedding materials. Using mattress or pillow encasements can help contain those allergens. Dehumidifiers can also be helpful to reduce the humidity in your home that dust mites and mold need to exist. Using air cleaners in your bedroom may also help reduce your exposure to allergens and irritants .;
Fda Approval And Long
In 2010, the FDA approved the Alair System for severe refractory asthma in adults.3 Individuals 18 years of age and older who have well-documented severe persistent asthma not well controlled on ICS and LABA and without any significant contraindications to bronchoscopy can be evaluated for BT. This evaluation is often performed by a specialist in asthma care and may or may not be the bronchoscopist performing BT. The FDA has required a postapproval study based on the long-term follow-up of patients in the AIR2 trial to evaluate durability of effectiveness of BT. A second postapproval study will be a prospective, open label, single arm, multicenter study conducted in the United States to demonstrate durability of treatment effect and to evaluate the short-term and longer-term safety profile of BT in the intended use population.
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Novel Treatments Driven By Asthma Endotypes
Precision medicine, which is fitting very well asthmas heterogeneity and complex pathogenesis, is becoming an overarching medical discipline that requires a good understanding of biomarkers, phenotypes, endotypes, genotypes, regiotypes, and theratypes of diseases. ICS have been the foundation for asthma treatment; however, inhaled or systemic corticosteroids can be ineffective in many patients with asthma. Few treatment options exist for patients with steroid-resistant asthma. The recent development of a new class of biological agents that target airway type 2 inflammation has provided an opportunity for treating patients with corticosteroid refractory asthma .
Several earlier studies have highlighted the impact of high-altitude treatment in atopic dermatitis and asthma., A recent study by Boonpiyathad et al described the clinical and immunological changes after high-altitude treatment in asthma patient subgroups and showed that clinical improvement is dependent on the asthma phenotype. Furthermore, high-altitude treatment reduced the type 2 immune response and corrected the elevated CRTH2 expression and its dysregulated functions.
EAACI recently launched its guidelines for the use of biologicals in severe asthma. Recommendations follow the GRADE approach for each biological and each outcome. In addition, a management algorithm for the use of biologicals in the clinic is proposed, together with future approaches and research priorities.
Allergen Immunotherapy And Allergen Avoidance Measures
Allergen-specific immunotherapy may be considered if allergy plays a prominent role . There are currently two approaches: subcutaneous immunotherapy and sublingual immunotherapy. Immunotherapy is associated with reduced symptom scores and medication usage, and improved allergen-specific and nonspecific AHR , although most studies have been in mild asthma, and only few studies have compared immunotherapy with pharmacological therapy. Moreover, potential benefits of allergen immunotherapy must be weighed against the risk of adverse effects and the cost of treatment .
Mite allergen avoidance is not recommended as a general strategy in asthma . In patients with mite-sensitive asthma, physical and chemical measures aimed at reducing exposure to house dust mite allergens do not appear to improve asthma symptom or reduce drug usage . However, the quality of the studies in the meta-analysis was low. Allergologists still advocate a measure to reduce the mite concentration at home . Conversely, dampness or mold removal in homes reduces asthma symptoms and medication use in adults .
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Knowing Your Asthma Action Plan Is Step One
For most people with asthma, managing the chronic condition involves a multi-pronged approach tailored to your symptoms and lifestyle.
Step one for everyone, however, is having a firm grasp of your asthma action plan.
Work with your doctor to create an asthma action plan that covers how to:
- Take your medication properly
- Quit smoking, if you do
In addition, monitor your symptoms carefully. Keep track of what they are, when they occur, and their severity.
Journal of Asthma and Allergy,
- In cold, dry air
- In environments with airborne irritants, such as cigarette smoke
How Do I Know If I Have Asthma
Asthma is a respiratory condition characterized by difficulty breathing due to narrowing of the airways leading to the lungs, including the nasal passageways, mouth and larynx. Symptoms can be triggered by things that irritate the airways and immune system.
When a person is having an asthma attack, they describe experiencing all or some of these symptoms:
- Wheezing with inhalation and exhalation
- Dry, hard cough
- Sweating
- Spasm of breathing muscles due to the effort of trying to breathe
An attack usually comes on suddenly but can be more gradual depending upon the trigger. It can disappear quickly, but if prolonged and severe enough, an asthma attack can result in death.
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Future Perspectives And Conclusion
Severe asthma is a heterogeneous and complex disease requiring a multidisciplinary approach. Identifying the true severe refractory asthma patient is the first step in management. The second step is to phenotype the patient as accurately as possible. Until now, only clinical phenotyping has been used in clinical practice to guide treatment. Unbiased cluster analysis has already revealed three to four subphenotypes of severe asthma . In the near future, integrated high dimensional data will probably lead to more accurate phenotyping . This will certainly improve our understanding of the patho-immunobiology of the different asthma phenoypes and will help clinicians to better predict the natural history and prognosis of an individual patient with asthma. However, the most important outcome of this systems medicine approach will be the development of new and better treatment targets/strategies for this complex group of patients with severe refractory asthma.
Targeting The Appropriate Therapy For Individual Patients
It is becoming clear that the key features of asthma: symptoms, disordered airway function, airway inflammation, exacerbations and long term decline in lung function, are not closely related to each other within patients and might have a different pathophysiological basis. Recent studies have questioned a direct causal association between eosinophilic airway inflammation and airway hyper-responsiveness, and have suggested that infiltration of airway smooth muscle by mast cells might be more important. In contrast, asthma exacerbations are more closely related to eosinophilic airway inflammation, such that the induced sputum eosinophil count has emerged as a good surrogate marker of exacerbation frequency. There is increasing evidence that some patients with asthma do not have eosinophilic airway inflammation and might not respond to inhaled corticosteroids.
Evidence for the efficacy of each class of treatment on the four major features of asthma
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