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post in: Health Date:24 Aug 2017, 09:11 views:3436
Asthma is a clinical syndrome characterized by episodic reversible airway obstruction, increased bronchial reactivity, and airway inflammation. Asthma results from complex interactions among inflammatory cells, their mediators, airway epithelium and smooth muscle, and the nervous system.
In genetically susceptible individuals, these interactions can lead the patient with asthma center to symptoms of breathlessness, wheezing, cough, and chest tightness. Causes or triggers of asthma can be divided into allergic and nonallergic etiologies. Aeroallergens can include seasonal pollen, mold spores, dust mites, animal allergens, and food (especially in children).
Monosodium glutamate does not appear to be an allergen. 1, 2, 3, nonallergic causes of asthma can include smoke, odors, cold air and weather, chemicals, medications (eg, aspirin and other nonsteroidal anti-inflammatory drugs nsaids beta-blockers exercise, hormonal changes (eg, pregnancy, menstrual cycle and bisulfite food additives. Genetic differences may alter susceptibility to asthma, as asthma well as responsiveness to asthma medications.
4, significant genetic variation exists between and within racial and ethnic groups, but the issue is confounded by important coexisting economic, cultural, and environmental differences, including geography (place of birth). 5, go to, pediatric Asthma, Status Asthmaticus, Exercise-Induced Asthma, and, asthma in Pregnancy for complete information on these topics.
In the United States, asthma is annually responsible for.5 million emergency department visits, 500,000 hospital admissions (third leading preventable cause and 100 million days of restricted activity. Medical expenses, as well as lost work and productivity, cost an estimated.7 billion in 1998. In Western countries, the financial burden on patients ranges from 300 to 1,300 per patient year, increasing with more severe disease.
Worldwide, economic costs for asthma are more than those for tuberculosis and acquired immunodeficiency syndrome (aids) combined. Cost is associated with disease severity 6 ; more than half of all expenditures are attributed to the 10-20 of patients with the most severe disease. Asthma risk factors, risk factors for asthma include a family history of allergic disease, the presence of allergen-specific immunoglobulin E (IgE viral respiratory illnesses, exposure to aeroallergens, cigarette smoke, obesity, and lower socioeconomic status.
A recent study by Zhang et al suggests that those children who are genetically predisposed to asthma may be at an even higher airway risk if they are overweight beyond infancy. 7, data from the Prevention of Allergy: Risk Factors for Sensitization in Children Related to Farming and Anthroposophic Lifestyle (parsifal) Study and the Multidisciplinary Study to Identify the Genetic and Environmental Causes of Asthma in the European Community Advanced (gabriela) Study reinforce the concept. 8, using a cross-sectional design, the authors compared children living on farms to those in a reference group with respect to the prevalence of asthma and to the diversity of microbial exposure.
The studies found that children who lived on farms had a lower prevalence of asthma and atopy and were exposed to a greater variety of environmental microorganisms than children in the reference group. The diversity of microbial exposure was inversely related to the risk of asthma (odds ratio for parsifal,.62; 95 confidence interval CI,.44-0.89; odds ratio for gabriela,.86; 95 CI,.75-0.99). Allergy-associated asthma, environmental exposure in sensitized individuals is a major inducer of airway inflammation, which is a hallmark finding in the asthmatic lung.
Although triggers induce inflammation through different pathways, the resulting effects all lead to increased bronchial reactivity. The importance of allergy in asthma has been well established. For example, exposure to dust mites in the first year of life is associated with later development of asthma and, possibly, atopy.
Mite and cockroach antigens are common, and exposure and sensitization have been shown to increase asthma morbidity. Allergies trigger asthma attacks in 60-90 of children and in 50 of adults. Approximately 75-85 of patients with asthma have positive (immediate) skin test results.