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Understanding the Pathophysiology of Asthma


Asthma is a disease of the airways that is variable and inflammatory. It causes recurring symptoms that last for small intervals and worsen the signs and symptoms of asthma. Asthma is systematic affecting the multiple organs beginning with inflammation in cells present in the lungs. The count of eosinophil in patients is notably high in the airways along with lymphocytes, mast cells and mononuclear cells. The infiltrate caused by the inflammation is related to the marked alterations in bronchi structure. The changes are smooth muscle hypertrophia, uncovered epithelium, hyperplasia and changed subepithelium indicated by collagen deposition.

Some evident signs of asthma are coughing, shortness of breath, wheezing and tightness in the chest. These symptoms are recurrent and happen because the airflow is obstructed. The condition is reversible either with treatment or extemporaneously. Millions of people across the globe are affected with this condition each year. Male children are more exposed to this disease and when it comes to adults, the occurrence is high in females.

Health experts say that asthma may be a result of environmental factors, different host factors or even a combination of the two. Some of the host factors include obesity, gender and genetics.

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Pathophysiology of Asthma

Understanding the pathophysiology of asthma assists in comprehending the proper diagnosis and treatment of this condition. There are many factors involved in the pathophysiology of asthma some of which include wheezing, shortness of breath, bronchiolar inflammation along with airway narrowing and resistance which comes out in the form of coughing. Asthma can affect the bronchi, trachea and bronchioles. Even if a patient of asthma doesn’t show any obvious symptoms and signs of the condition inflammation may be present.

Edema, bronchospasms, muscle or epithelial damage and excessive mucus can all lead to bronchoconstriction along with bronchospasm. Microvascular leakage cause edema and this narrows the airway. Also, the capillaries of the airway expand and leak leading to increased secretions thus causing edema and barring the path of mucus clearance.

Asthma also causes the mucus-secreting glands to expand which leads to growth in mucus-secretion cells. When the secretion of mucus increases, it leads to the formation of thick mucus plugs that hinder the airway. When the epithelium is harmed, it leads to epithelial peeling resulting in excessive impairment of the airway. When the epithelium barrier is susceptible, it lets the allergens pierce within which makes the airways hyperresponsiveness. The level of hyperresponsiveness is contingent on the level of a patient’s immunity and the inflammation.

Asthma also leads to loss of enzymes that usually break down inflammatory mediators and as a result, the sensory nerve exposure leads to reflexive neural effects. If the condition of asthma is not diagnosed and treated properly, it may cause the airway to be restructured which would cause the tissues and cells to alter in the lower respiratory tract. Such changes when happen lead to fibrotic damage which is irreversible even with treatment. It also would cause a loss in the proper functioning of lungs that would gradually get worse and slowly even therapy or medical help will not be of any help.

pathophysiology of asthma
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Types of Asthma

Occupational Asthma: There are several individuals that contract asthma because of their workplace environment. Gas, dust from asbestos or silica, fumes, smoke, etc. at workplace trigger symptoms of asthma. One may suffer from wheezing, irritation in the eyes, cough, congestion or runny nose.

Cough Variant Asthma: Cough is the main symptom of this type of asthma. There are other reasons for this type of asthma too which include chronic rhinitis, postnatal drip, GERD or gastroesophageal reflux disease and sinusitis. This type of asthma often goes undiagnosed. So, if someone is suffering from a continuous cough, then he or she should visit a doctor.

Nocturnal Asthma –Asthma is mostly influenced by sleep: This is because of certain changes that take place in our body at night which include cooling of the airway, hormone secretion in a circadian pattern, heartburn or reclining position. Symptoms include breathing problem which is quite dangerous and can cause deaths, cough and wheezing.

Allergies – Asthma: A good example would be allergic rhinitis which is commonly known as hay fever. The allergens usually enter the body through the airway. When an individual’s body is sensitive to a specific substance or allergens, then histamines are released. These histamines lead to symptoms of allergy. Scratchy throat, sneezing, runny nose, weepy eyes, swollen passages in the nasal area and mucus are some symptoms of this type of allergy.

Exercise-Induced Asthma: Exercise-induced asthma is elicited by physical exertion or exercise. This type of asthma is common in athletes who show symptoms like coughing and wheezing as they begin to exercise. The airway begins to narrow within 5 minutes of their exercising and may take as long as 20 minutes for the symptoms to show up.

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In order to asthma the diagnosis should be done deeply and should not just be limited to checking for symptoms for tightness in the chest, dyspnea, coughing, wheezing, running nose, etc. The practitioner should also check for symptoms that get worse at night but stabilize with medicine. Tests that are normally required for asthma are PEF or Peak Expiratory Flow and PFT or Pulmonary Function Test. Other tests help in determining the allergens or the stuff that you are allergic to such as pollen, certain food, gases or particles, etc.

Diagnosis of Asthma
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Controlling asthma includes long and short term treatments. The type of medication depends on various things such as severity of disease, the age of the patient and comorbidities (a condition where individuals have more than one condition or disease).

A patient’s full medical history in detail is compulsory before medication is prescribed to them.

Educating the Patients

Asthma symptoms could get life-threatening if not controlled on time. It is important to educate the patients and their families on how to understand the symptoms, use optimized environmental controls, use the medicines or inhalers, etc. Asthma-related vaccinations are good suppressors.


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