Bronchial asthma. Definition of bronchial asthma

Bronchial asthma (BA) has been known since antiquity (Egypt, Ancient Greece, China). Then, certain herbs containing ephedrine adrenergic agents or anticholinergic alkaloids were used in the treatment (for example, relief of attacks was achieved by smoking Datura grass). In those days, AD was treated as a symptom, and not as a disease. V. Osler first pointed out the role of inflammation in the genesis of AD, and P. Erlich first observed eosinophilia in sputum. Russian therapists G. Sokolsky and S. Botkin believed that the etiological factor in asthma is inflammation of the bronchi, against the background of which asthma attacks develop. In general, the essence of AD and its treatment were poorly understood until 1900. As early as 150 years ago, bronchial asthma was easy due to the lack of effective drugs for its treatment. French doctor V. Trousseau wrote that they do not die from asthma. Today AD is characterized by a more severe course and often poses a threat to the patient’s life (turns into a dangerous disease), despite the use of new, highly effective drugs. Evaluation of AD as an inflammatory disease is a major achievement in its history. This has shifted the focus in the treatment of AD from bronchodilating drugs to anti-inflammatory (GCS). The definition of bronchial asthma is based on the concept of chronic (often uncontrolled) inflammation of the airways, leading to bronchoconstriction, hyperreactivity and remodeling of the bronchi. AD is a chronic, persistent and progressive inflammatory disease of the respiratory tract, in the development of which many cells participate (including mast and eosinophils). In people with hypersensitivity, such inflammation causes: • recurring symptoms (especially at night and / or early in the morning) – suffocation, wheezing, heavy coughing and heaviness in the chest, usually associated with generalized, transient obstruction of all bronchi, small and large bronchi (in a short period of time, of varying severity), variable, fully or partially reversible in the interictal period (spontaneously or under the influence of treatment); • increased sensitivity of the respiratory tract to various stimuli (bronchial hyperreactivity). The definition of asthma is clinically functional and has no indication of etiology or structural changes. Key distinguishing features of AD are the reversibility of bronchial obstruction and their hyperreactivity, allergic inflammation. As a rule, most asthmatics do not have chronic disease progression. Partially reversible obstruction may also occur in diffuse lesions of the bronchi (in COPD).

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