Ten years later, we finally decided to translate the Brussels Declaration on Asthma into Russian.
The need for a change in approach to the diagnosis and treatment of asthma .
The prevalence of asthma has increased dramatically over the past 20 years, and the annual cost of the disease is now estimated at almost 18 billion euros across Europe. The incidence of childhood asthma has increased significantly: up to 20% of European children have asthma, and it has become the most common reason for hospitalization.
Although existing tools can help treat asthma, studies show that only 5% of European adults and children with asthma are actually controlled according to the Global Initiative for Asthma (GINA) criteria. In addition, there are no reliable criteria for diagnosing asthma, which vary across Europe, and researchers have not yet unraveled the complex genetic and environmental causes of the disease.
The Brussels Declaration on Asthma, adopted by the Asthma, Allergy and Inflammation Research Charity (AAIR), calls for urgent action by policymakers, regulators, physicians and patients to recognize that asthma is a serious public health problem that deserves to be a priority societal issue.
Changes in all approaches are needed to ensure that the diagnosis of asthma is accurate, that clinicians recognize the systemic inflammatory nature of the disease, and that patients across Europe receive treatment that provides optimal disease control.
In this context, the Declaration emphasizes that the region’s guidance on asthma since 2002 needs to be urgently updated to reflect the latest scientific research and, in particular, to recognize the importance of patient-centred outcomes, as is the case for other complex issues such as like diabetes and hypertension. It is also important to improve the process of treating children.
Last but not least, the Declaration calls for patients to be able to play an active part in this.
According to Stephen Holgate ( University of Southampton , UK), author of the paper that led to the adoption of the Declaration, “asthma is a public health problem affecting all age groups that requires decisive action at various levels. Including for diseases that coexist with asthma, as well as diet, air quality, exercise and housing. Programs are also needed to more adequately evaluate the use of anti-asthma drugs, taking into account patients’ concerns about side effects.”
The Brussels Declaration, available online at http://www.summitforchange.eu, calls for action on all these aspects and urges stakeholders to establish common criteria for monitoring and evaluating results.
Action is needed not only from governments, but also from physicians, patient groups and patients themselves to ensure better outcomes for asthma patients across Europe.
Commentary by Dr. V.N. Solopova: Society has long recognized the seriousness of the asthma problem. The declaration states that Europe’s losses from this disease amount to 18 billion euros and currently 20% of children suffer from this disease. Like this. “It’s time to think,” the declaration calls. But no one seems to care.
Asthma switch found?
Asthma ‘switch’ found? Fallacy or “scientific” speculation?
Asthma, allergies and a number of other diseases, such as rheumatoid arthritis, atherosclerosis, are caused by a chemical “switch” – protein substances of cytokines IL-4 and IL-10, which “trigger” the mechanism of an allergic reaction, American scientists report in an article published in the May issue of the Journal of Leukocyte biology .
“This study uncovers the underlying mechanisms that determine whether a person will have asthma or allergies and how severe the symptoms will be. This understanding paves the way for the treatment of these and other similar diseases,” says study lead author Professor John Ryan (John Ryan ) from the Commonwealth University of Virginia. His words are quoted in a report from the Federation of American Societies for Experimental Biology.
He and his colleagues in a series of experiments on laboratory mice studied bone marrow and umbilical cord blood cells associated with the appearance of a type of immune system cell, mast cells (mast cells ) . Too many mast cells lead to an overreaction of the immune system, which causes allergies and asthma. Researchers have found that protein substances – the cytokines IL-4 and IL-10, which trigger immune responses – can suppress the development of mast cells.
Since bone marrow cells produce both mast cells and cytokines, the researchers conclude that these substances are both a “trigger” of the immune response and its “switch”, which does not allow the reproduction of mast cells to get out of control.
In particular, this conclusion is supported by the fact that mice genetically vulnerable to allergic reactions were deprived of a gene that is responsible for the production of cytokines in bone marrow cells.
Comment. Here is a message from the “submission” of one of the news agencies was replicated on the Internet. Citizens! Don’t be so gullible! Of course, it’s great to assume (I think that journalists also distorted the information a little) that there are such convenient “switches” for all diseases in the human body. Half a century ago, our compatriot Buteyko recognized too “deep breathing” as one of such switches. So what? Nothing changed. Asthmatics over time smoothly move from the inventor’s respiratory panacea to hormonal drugs, slowly “curving back” from their illness. Well, now about the cytokines (or interleukins) IL-4, IL-10 and others. These substances are synthesized by one of the clones of T-lymphocytes-helpers that regulate the response of the immune system in the process of inflammatory, infectious and other reactions. Their role has long been studied in detail. And there is nothing surprising in the fact that bone marrow cells also produce interleukins, although, of course, this may be a new fact of medical science. However, the fact that they somehow influence the appearance of mast cells ( mastocytes ) in the human body does not make them universal “switches” (or, if you like, “switches”) of any diseases. After all, these researchers should be well aware that there are also non-immunological pathways for the release of substances that cause inflammation in the bronchial tree with asthmatic manifestations. Do you want an example? – Asthma with aspirin intolerance, or, as it is also called – aspirin asthma (which is actually not entirely true!). A few years ago, there was already one anti-asthma “sensation” – antileukotriene drugs. I recall that there were phrases about a “new era” in the fight against asthma. Alas, alas, alas… And now the article on bronchodilator drugs remains the most readable section on our resource. As they say, ” Berotek , he is in Africa – Berotek !”