Bronchial asthma is a chronic disease of the respiratory system. The etiology of the disease includes the following factors:
- heredity;
- ecology;
- profession;
- allergy;
- nutrition and being overweight.
Atopic asthma is caused by the body’s reaction to allergens and is often seasonal.
The methods of diagnosis and therapy depend on the origin of the disease. Typically, the diagnostic process includes blood tests and sputum tests. For treatment, antihistamines and bronchodilators are prescribed .
What is Atopic Asthma
Atopy is a genetic predisposition to allergic reactions. Asthma is a chronic inflammation of the respiratory tract. Therefore, atopic asthma is a respiratory illness associated with chronic or seasonal allergies.
The symptomatology is a sudden lack of air. It manifests itself in seizures, the first signs may be nasal congestion, rhinitis, cough, sneezing, itching of the skin.
For an accurate diagnosis, it is necessary to pass special samples and tests.
The mechanism of development of the disease
The development of atopic asthma is associated with immune processes in the human body. The immunological mechanism of atopic bronchial asthma is sensitization, that is, the development of hypersensitivity to allergens.
The person becomes especially susceptible to certain substances. When they re-enter the body, allergic reactions occur, as a result of which atopic asthma develops.
This is due to the release of inflammatory mediators in the body – histamine, cytokines and leukotrienes . The increased sensitivity of the bronchi to the allergen leads to obstruction. At the same time, their narrowing, reduction of smooth muscle fibers and the release of a viscous secret occur. In this regard, ventilation of the lungs decreases due to the limited passage of air flow.
Thus, the pathogenesis of atopic bronchial asthma is due to:
- Penetration into the body of the antigen.
- Synthesis of immunoglobulins E and G4 and their attachment to the outer surface of the cell.
- Isolation of inflammatory mediators (cytokines, leukotrienes , chemokines , etc.)
- The development of an early and late asthmatic reaction.
For non-atopic bronchial asthma, the mechanism of development is slightly different. First, there are violations in the mechanism of protection of the respiratory mucosa. After that, the body is exposed to infection. In response, it releases inflammatory mediators.
Further, enzymes are activated and changes in the work of nerve receptors occur. The process ends with disturbances in the work of the autonomic nervous system. Thus, the disease is associated with functional disorders, and not the action of allergens.
So, bronchial asthma has various mechanisms of development and pathogenesis. But it manifests itself in the same way – attacks of suffocation.
Types of atopic asthma
Depending on the type of allergen, atopic asthma is divided into several types.
Fungal
Fungal is asthma caused by various types of fungi. These can be fungi of the genus Candida , Aspergillums , Hormodendrum , Cladosporium , Alternaria and Penicilinum . In the first two cases, the disease worsens from September to March, in the second three – from July to September, and in the last – all year round.
The number of fungi due to reproduction in the daytime increases towards the evening. It was at this time and at night that exacerbations are observed. The weakening of the disease is possible in the cold period, but with the onset of heat, an exacerbation begins abruptly. It is also associated with an increase in the number of colonies of microorganisms.
The main place for the development of fungus in the house is the bathroom. It is imperative to monitor the moisture level in it and immediately fight the first signs of mold.
Nutritional
Nutritional asthma is a reaction to a variety of foods. It is usually accompanied by hives, swelling of the mucous membranes, dry cough, itching in the throat and ears.
Most commonly, food asthma allergies occur to the following foods:
- citrus;
- honey;
- chocolate;
- red vegetables;
- berries.
Usually the attack develops in an instant. The person feels severe difficulty breathing. But there are situations when it takes more than 4 hours before the first symptoms of allergy. The severity also varies, from nasal congestion to choking.
Particular attention should be paid to canned products. The fact is that canned food contains a large amount of salicylates – chemicals that in large quantities can cause an allergic reaction and cause anaphylactic shock. Salicylates are also found in medicines. They aggravate food allergies, complicating the course of the disease with drug allergies.
Pollen
Pollinosis symptoms
Pollen asthma is a disease caused by plant pollen. The mildest form of asthma, preceded by lacrimation and rhinitis. Most often it is seasonal, but a year-round variant of the disease is also possible.
The seizures are controlled more quickly with antihistamines than with other types. But this does not mean that when treating a disease, you need to limit yourself only to this. It is imperative to visit a doctor. Usually bronchodilator drugs are used in such cases . They, in turn, act on specific receptors in the airways.
The disease worsens from April to September, just during the flowering period. The body’s sensitivity is increased to the pollen of birch, poplar, alder, ragweed and other vegetation. All the year round, such a reaction can manifest itself on a hazel or sunflower. In this case, it is not recommended to eat nuts and vegetable oil.
Epidermal
Epidermal – asthma, aggravated by contact with animals. In this case, an allergic reaction manifests itself to their fur, epidermal particles and saliva. The attack begins with sneezing, nasal congestion, coughing, and progresses to choking. There may be a slight increase in body temperature.
This type of disease is less common than others, in about 5-7% of cases. More often it affects people whose profession is associated with animals. These can be livestock breeders, trainers, shelter workers.
At home, this allergy occurs to cats, dogs, hamsters, rabbits and parrots. It is noteworthy that birds rank second on this list after cats. Bird fluff asthma affects many people.
Causes of the disease and risk factors
The main factor contributing to the development of the disease is heredity. If a person in the family has people suffering from atopic asthma, then, most likely, he will be allergic to the same allergens.
This is especially true for pollen, that is, seasonal, bronchial asthma. An allergic reaction to pollen is usually transmitted in every generation. But it is worth noting that more often in the female line. This is the main difference from endogenous, that is, non-atopic asthma.
As for external reasons, such can be ecology, mold in the apartment, the presence of an allergen in food and at home, taking medications without a doctor’s prescription. Choking attacks can provoke:
- eating sweets, citrus fruits, nuts, milk and other allergenic foods;
- medications;
- pet hair;
- household dust;
- cigarette smoke;
- air saturated with industrial gases;
- temperature difference and high humidity.
Therefore, people living in a cold climate with high humidity or in an area built up with factories are twice as likely to develop atopic asthma as others.
Severity and Symptoms of Atopic Asthma
Mild persistent course – the degree at which the disease is mild. Continuous therapy is not necessary. Choking attacks occur about one to two times a week. They are short-term, pass on their own, worsen the quality of life and require referral to specialists.
Moderate severity – characterized by daily attacks and sleep disturbances. They must be stopped by bronchodilators – bronchodilator drugs prescribed by a doctor.
The severe form of the disease is characterized by daily attacks several times a day and night. A normal active life with this form becomes impossible. In this case, the course of the disease should be under strict medical supervision.
A typical feature of atopic bronchial asthma is status asthmaticus – a condition in which prolonged suffocation occurs up to loss of consciousness. In this case, in the absence of fast and qualified medical care, a lethal outcome is possible.
The symptoms of atopic bronchial asthma are as follows:
- whistling in the chest;
- wheezing sensation;
- sneezing;
- itchy throat;
- dry cough;
- dyspnea;
- pain and tightness in the chest;
- suffocation;
- fear, panic attack is possible.
The disease can manifest itself in various combinations of the listed symptoms.
Atopic asthma in a child
Children can also get atopic asthma . This is due to the high probability of transmission of the disease from parents. Often the disease in babies is confused with bronchitis.
But experienced professionals can make the correct diagnosis. The child needs a consultation with a pediatrician and an allergist. At the beginning of the disease, one can trace: shortness of breath, cough, noises in the chest.
Usually atopic bronchial asthma is diagnosed at the age of 6-10 years. But there are cases when very young children are susceptible to the disease. Then the disease manifests itself after a year of life. If the diagnosis has already been made, then there should always be drugs at hand to stop seizures.
The child’s room should be ventilated regularly, at least several times a day. In emergency situations, when the attack does not go away with the help of bronchodilators in 5 minutes, be sure to call an ambulance.
Diagnostics
A therapist deals with the diagnosis of bronchial asthma. If you suspect an atopic form of the disease, you should immediately make an appointment with an allergist and pulmonologist. After that, the doctor who is engaged in identifying the disease begins to find out which allergen could contribute to the appearance of atopic bronchial asthma.
To do this, he injects an allergen and monitors the development of the body’s reactions, if asthma symptoms occur, then the diagnosis is confirmed. Also, to diagnose the disease, doctors use the following types of laboratory tests:
- inhalations with identified antigens;
- skin tests;
- determination of the level of immunoglobulin.
Treatment for atopic asthma
Therapy for atopic asthma depends on its severity. A mild form of the disease is treated with short-acting bronchodilators directly during attacks.
The route of administration can be oral or inhalation. In the case of a severe course of the disease, anti-inflammatory drugs are used on an ongoing basis. In addition, hormonal treatment with corticosteroids is performed.
With status asthmaticus, oxygen therapy is prescribed; in extreme situations, artificial ventilation of the lungs, potent analgesics and the introduction of a special solution into the bronchi to clear mucus are used.
Plasmapheresis can be used to reduce the number of immune cells in the plasma that are sensitive to inflammation. Also, hemosorption is used to lower the level of antigens in the blood. With the disease, immunocorrection , physiotherapy exercises and sanitary-resort treatment are indicated .
During an attack, emergency assistance should be as follows:
- try to remove all possible sources of an allergic reaction;
- call an ambulance;
- provide the patient with access to fresh air;
- release the upper body from pressure clothing;
- use a bronchodilator drug, specifying the dosage in advance.
A patient with such an ailment needs to maintain a healthy lifestyle and play sports. This will help increase your maximum lung capacity. In the house of asthmatics, wet cleaning should be constantly carried out, eliminating household dust and animal hair.
In the case of food allergies, it is necessary to choose the right diet and observe dietary restrictions. The patient is strongly advised to quit smoking and choose environmentally friendly places to live.
Prevention of exacerbations of atopic asthma
There are no clear instructions for the prevention of atopic bronchial asthma. If the disease has not manifested itself in any way, experts can give the following recommendations: lead a healthy lifestyle, completely stop smoking, clean the house regularly, treat colds in a timely manner and spend more time in the fresh air.
For patients with asthma and for people at risk, prevention measures will be much stricter:
- eat only hypoallergenic foods;
- give up perfumes, air fresheners and cosmetics;
- remove all flowering plants;
- be careful about the sudden change in climate;
- avoid excessive physical exertion [M54] .
All this will help to avoid atopic asthma.