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 Asthma

 Asthma is a respiratory problem where the trachea (wind pipe) contracts as a result the air passage gets narrower which results in breathing problem or shortness of breath.

Etiology

Asthma can result from:

1. Inflammation

2. Autonomic Nervous System 

3. Allergy 

Inflammation:

Inflammation in the smooth muscle of bronchi can lead to asthma as due to inflammation the passage of the bronchi gets reduced.

Autonomic Nervous System:

Acetylcholine binds to the muscarinic receptors present on the smooth muscles of bronchi which lead to contraction of smooth muscles as a result the lumen size of the bronchi gets reduced. 

Allergy:

If the allergen gets trap in our bronchi or trachea it results in inflammation which in turn reduces the air passage of the bronchi.

Sign & Symptoms 

1. Shortness of breath 

2. Breathing rate is decreased

3. Insomnia 

4. Condition worsens during night time

5. Chocking 

6. Dyspnoea

7. Whooping cough 

Cause of Asthma

1. Air pollution

2. Cold air

3. Infection

4. Irritant 

Types of Asthma

1. Intrinsic Asthma

• Seen in early age – genetic

• Episodic – once in a day or once or twice a week

• Allergic history 

2. Extrinsic Asthma

• Seen in middle age 

• Chronic 

• No genetic history 

Mechanism 

This mechanism is based on the inflammatory mediators which are released from the mast cell and mast cells are abundantly present in our lungs. When any allergen (antigen) enters the body through the trachea and reaches our lungs, it binds to the IgE receptors (Antibody) present on the mast cells found in lungs and forms an Antigen-Antibody Complex (Ag-Ab complex). As the Ag-Ab complex is formed, granulation takes place in mast cell which result in formation of several granules which in turn secrete inflammatory mediators such as histamine, prostaglandin, protease enzyme, leukotrienes, etc. which causes inflammation to the bronchi smooth muscles of trachea. As a result, mucus is released and swelling takes place (bronchi contraction). Due to broncho contraction, the air passage becomes narrower. 

Treatment 

Wear mask as a result the allergen won’t enter the lungs

Inhibit the binding of antigen to antibody receptor – Omalizumab 

Weakening the Ag-Ab complex so that granulation doesn’t take place – corticosteroids: Hydrocortisone, Prednisolone, Fluticasone, Budesonide etc. 

Mast cell stabilizer – Sodium cromoglycate, Ketotifen

Bronchodilator – Salbutamol, Terbutaline, Bambuterol, Theophylline, Ipratropium bromide etc.

                                         Article by: Ashaya Desai