The causes of asthma are polyetiological and can be varied. The main impetus for the occurrence is the inflammatory process, which is chronically present in the bronchi and leads to their morphological changes.
There is no reliable answer to the question of the causes of inflammation in modern medicine; the list of what can provoke an asthma attack is incomplete. The prevalence of the disease led to the need to study it, but even after many years of research, its etiology and pathogenesis are still not fully understood.
What is bronchial asthma
The disease is an inflammatory process in the airways that does not involve infection. Asthma provokes the permanent occurrence of bronchial obstruction syndrome, in which the mucous membrane swells, smooth muscles spasm and mucus hypersecretion is observed.
Asthma suffocation is provoked by pathological changes that have occurred in the bronchi under the influence of constant inflammation. Spasm, swelling and excess phlegm cause coughing – the result of the activity of the cough center in the brain.
Types of asthma and the mechanism of development of the disease
The disease is differentiated according to several characteristic features, including:
- etiology (causes and mechanism of development of an attack of bronchial asthma);
- main provoking factors;
- severity;
- form of bronchial asthma (how bronchial obstruction proceeds).
During the period of exacerbation, there is a separate distinction (according to the severity of the exacerbated pathology). The patient’s history must indicate the level of control of the patient over the manifested symptoms. A single classification that would take into account all the features does not yet exist. The disease is multifaceted, and several categories of signs are used to characterize the clinical picture in an individual patient.
The classification by nature of origin takes into account how bronchial asthma begins. It includes factors that give rise to the mechanism of development of bronchial asthma, although sometimes they can act in a cumulative interaction. At the same time, the role of atopy (hereditary diseases leading to the development of allergy to a certain provocateur) in the development of bronchial asthma is practically not taken into account . Modern medicine differentiates the following types of disease:
- allergic, which has arisen under the influence of a potential allergen, the role of which can be many factors – from food to pollen or odor;
- infectious, the likely cause of the development of which was the transferred infection (fungus, virus, bacteria, parasitic invasion);
- aspirin provocateur can be not only the intake of ASA (acetylsalicylic acid), but also the abuse of other non-steroidal anti-inflammatory drugs;
- professional is manifested after work in hazardous production and is the result of labor activity;
- exercise asthma is a form of the disease in which symptoms occur after intense physical exertion;
- nocturnal is not in all classifications, but some doctors distinguish a disease as a separate type, the symptoms of which appear only at night;
- reflux-induced is caused by abnormalities in the gastrointestinal tract, in which the contents of the stomach are thrown back into the esophagus or bronchi.
Etiological differentiation divides asthma into three main groups:
- endogenous, when internal factors ( infections, gastric reflux, a state of emotional instability or stress) become the cause of obstruction ;
- exogenous, arising under the influence of external provocateurs;
- mixed type, when the joint influence of endogenous and exogenous factors is possible.
Other types of classification
According to the level of disease control, the patient may have a well or partially controlled form. It is also possible uncontrolled, which occurs often, with which the patient cannot cope on his own.
The mechanism of development of obstructive syndrome in all asthmatics follows a similar scenario: after exposure to a provoking factor, spasm of smooth muscles occurs . This happens quickly enough due to morphological changes in the epithelium, thickening of the mucous membrane and poor blood circulation.
The mucous membrane swells, hyperproduction of secretion begins . The phlegm fills the airways and needs to be eliminated, which is what causes a cough. The cough center, located in the brain and responsible for stimulating the reflex, thus tries to free the airways for the normal breathing process.
For the development of the inflammatory process, which became the reason for the onset of the disease, there are numerous prerequisites both inside the human body and outside it. They are divided into external and internal. Both those and others can serve as a reason for the development of the disease.
Causes of bronchial asthma
The causes of asthma have been the subject of multivolume research in clinical medicine for decades. To the question of why asthma begins, and in the case of other common diseases of our time, it was not possible to find a reliable answer. The causes of the inflammatory process in the bronchi, which provokes asthma, in some cases could not be determined.
It is absolutely reliably known that the likelihood of developing bronchial asthma is at the genetic level and in some cases is inherited. However, in some people the disease begins in childhood, in others it manifests itself before the age of 40, and in the third group, which makes up about 20% of the total number of cases, it develops in the second half of life. The causes of bronchial asthma disease can be very diverse:
- permanent or episodic exposure to infection: bacteria, viruses, fungus, parasitic invasion;
- presence in the environment of non-infectious allergens: chemicals, waste products of plants and animals, dust, food products and additives, both natural and synthetic;
- the impact of environmental conditions (pressure and temperature drops, changes in the composition and humidity of the air);
- taking certain medications unnecessarily, in excess of the recommended dosage or for a long time;
- permanent stress, conflict situations, negative experiences, disorders of nervous activity can also provoke the development of inflammation;
- work in hazardous conditions, when a person is constantly exposed to chemical compounds, high or low temperatures, dust, steam;
- bad habits: smoking as a reliably established factor, alcohol abuse, taking any drugs.
Hereditary predisposition, which is often put at the forefront, is a frequent, but optional condition for the development of the inflammatory process. Not everyone who should have inherited the disease will develop the disease. However, the risk of its occurrence if one of the parents had a similar pathology increases many times over.
Risk factors
Studies have shown that genes responsible for the development of the disease are embedded in chromosomes 5 and 11, but heredity is not its only cause. Bronchial asthma is a multifactorial phenomenon, and triggers are needed for its occurrence.
The word “trigger” has many meanings, but everyone has the same meaning. Its literal translation is “trigger” or “activating”. In medicine, this is the name of any provocateur that triggers an exacerbation of a chronic disease, or negative changes in a relatively healthy body, leading to the development of pathology.
Risk factors for bronchial asthma are numerous and surround a person throughout his life. The risks of developing asthma are differentiated between those acting from the outside and those present in the body itself.
These are quite large groups, united according to very conditional criteria. But there is another classification that divides the risks of asthma into those leading to dangerous attacks and provoking the onset of the development of the disease.
Internal factors
Some endogenous risk factors for bronchial asthma are laid down even before a person was born. This is his belonging to a particular race and nationality, gender, and a genetic predisposition passed on by his parents.
The baby is already at risk if the risk factors are passed on at conception and birth. But with a potentially possible hereditary bronchial asthma, boys get sick more often in childhood due to the peculiarities of the structure of the respiratory tract. In girls, this likelihood increases during puberty, against the background of hormonal changes.
Representatives of the white race get sick more often than others, but among Caucasians, some nationalities are more susceptible to asthma, while others are less. Internal factors include dietary habits and metabolic features associated with the permanent use of certain foods.
In old age, they include the aging of the body and age-related changes occurring against the background of the termination of the reproductive system. A congenital developmental anomaly and a hereditary systemic disease can also act as a provoking factor.
External factors
Exogenous risk factors for asthma sometimes include those that are provoked by endogenous ones. For example, overweight or obesity, which may be a consequence of endocrine pathologies, are invariably indicated among the risk factors for the development of bronchial asthma.
An external factor in the development of bronchial asthma – living and living conditions, the choice of a profession, where there are harmful conditions, unfavorable ecology (a frequent occurrence in megacities) – sometimes does not depend on the potential patient. He lives in the place where he was born, in a house that was inherited, along with all the negative phenomena such as lack of fresh air, fungus in the room, plants planted decades before his birth.
They start smoking when there is already an example in front of their eyes, medicines are habitually taken on the advice or recommendation of parents. The choice of a profession is also determined by family traditions or the lack of other work in a particular area. Sooner or later, given the prerequisites, the time comes when all the existing factors trigger each other.
The disease is considered multifactorial due to the fact that several causes of a different plan are needed for its occurrence. But to start the first attack, additional conditions are needed , which the second classification provides.
Possible triggers of asthma
Asthma triggers are possible provocateurs or pathogenic agents, a special condition of the body or external conditions. This is all that causes an asthma attack with an already existing inflammation in the bronchi, but in a state of remission.
The trigger of bronchial asthma is its main provoking factor, but sometimes an attack can provoke an emotional outburst or stress, cold or hot air, physical effort or an associated infection.
The multifactorial nature of the process fully allows the development of an attack due to spontaneous negative emotions, a pathogenic agent or atmospheric phenomena, even if other causes are recognized as the main triggers of asthma:
- the presence of allergenic components in the air can negatively affect the general condition and lead to the development of an attack, as well as suddenly changed weather conditions;
- smoking, even passive (if they smoke indoors or outdoors), smoke from a hookah or fireplace, the presence of ash and coal particles in the air can lead to the development of obstructive syndrome against the background of a narrowed airway lumen or drunk alcohol, emotional stress, unpleasant experiences;
- any active activity requiring physical effort, increasing the volume of inhaled air. Such an action can provoke an attack, and it does not matter what kind of effort it is and what its nature is (lifting weights, intercourse, or running after a departing vehicle);
- Infectious-bacterial asthma in children is a clear evidence of the fact that in one clinical picture there can be several triggers at once, and the first is a chronic infection, to which a bacterial infection joins, and only then the inflammation process begins to rapidly progress.
The origin of the disease, which affects one in eight people in Western Europe, can be associated with many factors present inside the human body or in its environment. Recently, the development of the process against the background of taking medications has often been noted. Therefore, it is necessary to take certain measures to prevent and prevent morbidity.
Prevention of asthma
Distinguish between primary and secondary prevention of the disease. Primary involves the elimination of provocateurs that can lead to asthma. So that people at risk are not exposed to the factors causing asthma, an external stimulus to which a negative reaction has been noted is eliminated.
Secondary prevention of bronchial asthma consists in maintaining clean air, following the rules of hygiene, taking medication only as prescribed by a doctor, maintaining a healthy lifestyle and giving up bad habits. These measures are necessary to avoid the occurrence of seizures or further development of the pathological process.