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What causes Asthma?
Asthma is a disorder of the respiratory system in which the passages that enable air to pass into and out of the lungs periodically narrow, causing coughing, wheezing, and shortness of breath. This narrowing is typically temporary and reversible, but in severe attacks, asthma may result in death. Asthma most commonly refers to bronchial asthma, an inflammation of the airways.
More than 17 million Americans suffer from asthma, with nearly 5 million cases occurring in children under age 18. In the United States, asthma causes nearly 5,500 deaths each year. Asthma occurs in males and females of all ages, ethnic groups, and socioeconomic levels. For reasons not completely understood, asthma is generally more common in poor urban neighborhoods, in cold climates, and in industrialized countries.
Among all Americans, the prevalence of asthma increased more than 60 percent between 1982 and 1994, especially among children. Deaths from asthma increased more than 55 percent from 1979 to 1992. Scientists suspect that increased exposure to second-hand cigarette smoke, growing populations in polluted city centers, and new housing that is poorly ventilated contribute to the increase in asthma cases.
For some people the environmental triggers are allergens. Allergens are usually natural substances, such as plant pollen and mold spores, animal dander (tiny pieces of animal hair and skin), and fecal material from dust mites and cockroaches. Allergens produce an exaggerated response of the immune system in which a specific antibody, immunoglobulin E, initiates the inflammatory response. These same allergens may cause little or no reaction in nonallergic people (see Allergies).
Asthma also occurs in people who do not have allergies. In these people, chemical irritants trigger an inflammatory response that is initiated in a different way than in allergen-triggered asthma. For example, some people are sensitive to certain common chemical irritants, such as perfume, hairspray, cosmetics, and household cleaners. Other chemical irritants include industrial chemicals and plastics, as well as many forms of air pollution, such as exposure to high levels of ozone, car exhaust, wood smoke, and sulfur dioxide. Current research seeks to determine whether indoor pollutants also contribute to the development of asthma.
What are the symptoms of Asthma?
Physicians typically diagnose asthma by looking for the classic symptoms: episodic problems with breathing that include wheezing, coughing, and shortness of breath. When symptoms alone fail to establish a diagnosis of asthma, doctors may use spirometry, a test that measures airflow. By comparing a patient’s normal airflow, airflow during an attack, and airflow after the application of asthma medication, doctors determine whether the medicine improves the patient’s breathing problems. If asthma medication helps, doctors usually diagnose the condition as asthma.
Identifying the specific trigger of a patient’s asthma is usually more difficult than the initial diagnosis. Triggers may be easily recognizable and consistent; for example, a patient may always develop an asthma attack when using a particular cosmetic or household cleaning product. When the triggers are more difficult to identify, doctors perform a series of allergy skin tests to help determine whether allergy triggers are responsible. Skin tests are not conclusive, however, because patients may have skin reactions to substances that do not necessarily trigger an asthma attack. Doctors may also use spirometry to evaluate a patient’s airflow before and after exposure to common triggers. Triggers that decrease airflow may be responsible for the patient’s asthma.
What are the treatments for Asthma?
Bronchodilators are the most widely used medications for controlling sudden asthma attacks and for preventing attacks brought on by physical activity or exercise. They work directly on sites called beta-receptors that are attached to small muscle bands encircling the airways. When these drugs attach to the beta-receptors, the muscles relax and the airway dilates. Theophylline is a bronchodilator that works by relaxing the muscles surrounding the airways.
Anti-inflammatory medications work mainly by interfering with the activity and chemistry of immune cells, such as mast cells, that cause inflammation in the airway walls. Anti-inflammatory medications also help relax the airway muscles that constrict during bronchospasm. Corticosteroids reduce asthma symptoms by suppressing the immune response, and they often succeed when no other asthma treatment works. Over time they reduce the sensitivity of the airways to many common triggers. Long-term use of oral corticosteroids may have severe side effects, including weakening of the bones and the development of cataract, a clouding of the lens of the eye. Recent studies suggest that small doses of inhaled corticosteroids taken in combination with certain bronchodilators may work equally well while significantly reducing the side effects. Leukotriene modifiers, another type of anti-inflammatory medication, are taken orally as an alternative to corticosteroids for the long-term treatment of mild asthma.
Immunotherapy is a treatment option for asthma caused by allergens. This form of therapy modifies a person’s allergic response by repeated exposure to small amounts of allergens. The asthmatic is injected periodically with known allergens, a procedure that trains the asthmatic’s body to react to the allergens differently. Immunotherapy is especially effective in reducing allergic reactions to dust mites, animal dander, pollen, and fungi.
To control asthma attacks before they begin, asthmatics can measure their peak expository flow rate (PEFR), which is a gauge of how fast a person can exhale air from the lungs. By breathing into a small hand-held device called a flow meter, an asthmatic can learn when their airways are first starting to narrow. When the PEFR falls, asthma medication may be needed to prevent an attack. PEFR and medication should be used under a physician’s guidance.
Asthmatics can also prevent and control attacks by limiting their exposure to environmental triggers, especially allergens. Frequently cleaning carpeting, bedding, and household upholstery reduces levels of irritants and allergens in the home. To prevent asthma attacks, asthmatics should wear a mask while cleaning. Regularly bathing pets minimizes levels of animal dander in the air. Asthmatics should take care to avoid pollutants and irritants such as cleaning sprays and cigarette smoke whenever possible. Seasonal allergies to pollen and mold spores can be reduced by avoiding the outdoors during peak periods of activity.
Ref: Microsoft® Encarta® Online Encyclopedia 2007, © 1997-2007 Microsoft Corporation
Immunotherapy ("allergy shots")
Allergy shots have been used since 1911. This time-tested therapy decreases a patient's 
sensitivity by introducing increasingly larger doses of the substances to which the patient is allergic. The treatment is a method for increasing the allergic patient's natural resistance to the things that are triggering the allergic reactions.
The immunization procedure begins with injections of small amounts of purified "extracts" of the substances that are causing allergic reactions. For example, the extracts may be derived from pollens, mold spores, animal dander, dust mites or insect venom. They are approved for this use by the U.S. Food and Drug Administration, and over the years they have been improved considerably.
Allergy shots stimulate the immune system to fight allergies safely, effectively and naturally. Beginning with small doses and increasing them gradually on a weekly or biweekly basis, the therapy continues until a maintenance level is achieved. Then, a maintenance dose is injected every few weeks.
Immunity does not occur immediately, but patients do begin to feel better quickly. In some patients, immunity is maintained and treatment can be discontinued after several years. For others, treatment may be needed for longer periods of time.
With the immune system restored to good health, few or no medications may be needed. Work or school days are no longer missed. The burden of allergies is lifted, and allergies become something you just don't think about any more.
Candidates for immunotherapy include patients of all ages. (Normally children under the age of two are not prescribed immunotherapy injections.) Pregnant patients should continue treatment started prior to pregnancy.
Allergy shots are always given under medical supervision at a location where medical staff and medications are available to handle any serious reaction. Although rare, systemic reactions can occur for allergy shots because the treatment involves the substances to which the patient is known to be allergic.
How allergy shots can help control increasing Asthma rates
- Asthma, a chronic inflammation of the lung airways characterized by wheezing, coughing, chest tightness and shortness of breath, affects 17 million Americans.
- Since 1980, asthma has increased by 160 percent among children age 4 and younger.
- Approximately 80 percent of all asthma in children and half of all asthma in adults is caused by allergy.
- An international conference, "Immunotherapy in Allergic Asthma," hosted by the American College of Allergy, Asthma & Immunology (ACAAI) in 2000, concluded that immunotherapy (allergy shots) is an effective treatment for allergic asthma, and can prevent the onset of asthma in children with allergic rhinitis.
- The Preventive Allergy Treatment (PAT) study, published in the February 2002 issue of the Journal of Allergy and Clinical Immunology (JACI), confirms the ACAAI conference conclusions. The study documents that immunotherapy reduces the risk of developing asthma and reduces lung airway inflammation in children with hay fever, a condition that predisposes them to asthma.
- The study followed 205 patients ages 6 to 14 from six pediatric centers in Sweden, Norway, Denmark, Finland, Austria and Germany; a total of 191 patients completed the study. The children all had proven allergies to birch or grass pollen or both. Before the start of immunotherapy, more than 20 percent (40 of 191) children had asthma symptoms during pollen season, even though they initially reported no history of asthma; 151 children had no asthma symptoms.
- The children were randomly assigned to receive either medications alone to control their symptoms or those medications and allergy shots that treated their allergic condition; they were tested for symptoms of asthma after three years of treatment. Among those who had no asthma prior to treatment, only 24 percent of those receiving allergy shots (19 of 79) developed asthma, compared to 44 percent of those who did not receive shots (32 of 72).
Allergy Partners, P.A. specializes in providing Immunotherapy treatments for wide range of allergens. Allergy Partners, P.A. also blends and controls purified extracts for Immunotherapy treatments in-house to assure the highest levels of purity and quality control.