Main Insidiousness of Asthma - Essay Example

?Asthma Introduction Asthma is known to be a chronic disease, encompassing varied and frequent symptoms resulting in impediment of reversible airflowdue to inflammation of inner walls of airways, generating sensitivity to irritations and thereby augments susceptibility to allergies. Swelling results in narrowing of air passage to and from the lungs causing bronchospasm, associated with puffing, cough, stiffness in chest and shortness of breath. Asthma is a result of deregulated immunological condition in respiratory mucosa; the condition is gaining prevalence across the globe and shows drastic augmentation since 1970s. It is reported that in 2009, 300 million people were influenced worldwide with asthma and there were 250,000 deaths reported due to asthma in 2009 (Web. "Asthma Statistics", n.d.). Industrialization has not only influenced lifestyles, environmental changes but also predisposed alteration in genes as individuals are now exposed to numerous environmental agents encompassing tobacco, smoke, pollen etc (Gilmour et al., 2006). These factors contributed to the augmented frequency of asthma. According to Umetsu and Dekruyff (2006), numerous research studies reveal that avid T-helper 2 (Th2)- driven responses results in asthma proliferation. CD4+ T cells making Th2 cytokines play an imperative role in lungs of asthma patients. The chief reason is interleukin-4 (IL-4) and IL-13 augments the level of (immunoglobulin E) IgE whereas IL-4, IL-9 and IL-10 augment mast cell proliferation, IL-5 enhances eosinophil accretion while IL-9 and IL-13 directly cause mucus hyper-secretion and airway hyperactivity (Umetsu and Dekruyff, 2006). These studies highlight the fact that allergy and asthma are compound genetic attributes, however in the proliferation of asthma numerous environmental factors encompassing allergens and pollutants play an imperative role. These act as stimulating factors and trigger genes to influence the propagation of asthma. It is evident that every individual is exposed to the allergens and other triggering agents but the condition of asthma is observed only in some sensitive individuals, underlining the importance of interaction between environmental and genetic factors in the development of asthma condition. Other preventive mechanism involves immunological factors that play the necessary role in preventing allergic and asthma condition needs further exploration (Umetsu and Dekruyff, 2006). Signs & Symptoms Coughing, wheezing, congestion or tightness in chest and difficulty in breathing or shortness of breath. Etiology According to Yeatts et al., (2006), reports are available displaying numerous windows of exposure present the onset of asthma condition. These conditions may be witnessed right from the fetal stage in utero condition, which is directly influenced by the timing of T-cell memory programming as well as genetic predispositions to such conditions especially in case of atopic parents because of underdeveloped immune system of the fetus. Maternal smoking (includes nicotine and carbon monoxide which diminishes blood cytokine levels, stiffens the uteroplacental circulation and augments the discharge of catecholamines, a direct implication on fetal breathing movements), consumption of alcohol during pregnancy drastically influence the development of asthma, followed by the condition of obstetric complications and elective cesarean section. Asthma during childhood is attributed in 80% of the cases to genetic susceptibility where males show 2-4 times greater frequency as compared to the females. In adults asthma is attributed to the environmental conditions, lifestyle, smoking habit and occupational hazard. As the age progresses exposure to environmental conditions and also occupational hazard increases which may augment the chances of asthma proliferation (Yeatts et al., 2006). According to Khetsuriani et al, (2008), there is a relationship between human rhinovirus (HRV) and asthma. Molecular characterization methodology was adopted in the study to examine HRVs in asthma cases. Their findings bring to focus that genetic diversity of HRVs is responsible for asthma prevalence in children. The diversity of the viral strain is attributed to its geographical distribution and environmental conditions. The study supports that HRVs act as human pathogens and has role in inducing asthma. According to Umetsu and Dekruyff, (2006), mechanism through which an individual displays tolerance to allergens and other environmental agents are inadequately investigated, although most of the recent studies are focused on the role of regulatory T cells (Tregs) in managing Th2-biased reactions. Further, regulatory T-cells which are involved in regulating the condition of allergy and asthma encompass a family of correlated T cells such as natural CD25+ Tregs as well as antigen-specific adaptive Tregs. However, developmental inability of these Tregs leads to the growth of allergy and asthma condition, methods which promote the generation of preventive Tregs or the methods which help in the introduction of these preventive Tregs in the patient could be a therapeutic progress in contrast to the conventional asthma treatment involving bronchodilators and anti-inflammatory. Removal of anergy of allergen specific cells, or through the expansion of Tregs (natural Tregs and adaptive Tregs), tolerance towards allergens could be enhanced which may provide long-lasting protection and check on the allergies and asthma condition (Umetsu and Dekruyff, 2006). Risk Factors Genetics & Environment Individual's susceptibility which is determined by numerous susceptibility factors (such as age, genetics and genetically at risk, diet, lifestyle) are related to the occurrence and generation of asthma. Thus, numerous environmental factors are responsible for the augmentation in asthma patients (Yeatts et al., 2006). Further, tracing the history of asthma patients highlight the fact that the condition is genetically inclined. Specific genes are associated with the susceptible cases which are difficult to replicate under laboratory conditions (Hoffjan et al., 2003). Prenatal risk factors including tobacco smoke and diet Maternal smoking is found to be associated with the childhood wheezing (Tariq et al., 2000). Prenatal nutrients or other dietary interventions encompassing omega-3-fatty acids and antioxidants like zinc and vitamin E minimize the risk of wheezing (Mihrshashi, 2007). Respiratory factors Numerous respiratory infections are responsible for inducing asthma. Considering environment to be the chief source of inciting asthma and numerous allergic conditions it is evident that prevalence rate of obesity in United States and around the world is increasing, moreover, the condition of asthma in obese individuals could be directly related (Yeatts et al., 2006). Other factors may include stress, use of antibiotics or exposure to animals may induce asthma in sensitive individuals. Diagnosis Family history of the disease condition, physical examination showing asthma symptoms or allergies such as running nose or eczema. Various diagnostic tests could also be used to diagnose the condition of asthma such as lung function test with the help of spirometry, by performing bronchoprovocation, chest X-ray and electrocardiogram (Web. "How is Asthma Diagnosed?", n.d.) Prevention Asthma is a condition that affects approximately 15 million Americans, of these 5 million belong to the age less than 18 years. According to National Asthma Education and Prevention Program of the National Institutes of Health, prevalence percentage of asthma increased approximately 75 percent, further, more than 7 percent children are the victims of asthma. Recent research studies highlight the fact that asthma-related hospitalizations are avoidable if the allergen or the environmental factors triggering the allergic and asthma response could be prevented. One of the studies, LET'S Manage Asthma, encompasses behavioral intervention where the exposure of the child to environmental tobacco smoke (ETS) is minimized by educating parents as well as care providers. Another study involves adults, Better Outcomes of Asthma Treatment (BOAT), which encompass adherence of the patient to the therapeutics ("Advancing Research in Asthma", n.d.). Treatment Pharmacotherapy of asthma involves anti-asthma drugs, the relievers, to relieve the patient from the symptoms of asthma, and the controllers for the prevention of symptoms associated with asthma. Immunomodulators and immunosuppressors modulates the imbalance of Th1 and Th2 as asthma is known to be cause by Th-2 polarized immunity. For instance Suplatast, possess high level of effectiveness. Anti-inflammatory agents involves corticosteroids, mast cell stabilisers and autocoid inhibitors. It is evident that the combination of inhaled corticosteroids and long acting beta2 agonist provides superior outcomes as they display synergistic anti-inflammatory effect in contrast to the corticosteroid alone. In present therapeutics besides leukotriene and thromboxane A2 inhibitors; prostaglandin D2 antagonist, PGE2, EP3 agonist and PGI2 agonist are also recommended (Nagai, 2012). Prognosis Although it is a long term condition and can be controlled but there is no definite cure to the disease. It is advised to keep away from the triggering allergens and irritants, tobacco smoke, smoke or smoggy conditions of environment, high BMI or obesity, pregnancy may also lead to asthma, stress could also induce asthma or inheritance. In some cases airway hyperactivity could also trigger asthmatic attacks, in some cases atopy could also result in asthma. Conclusion The present article is an attempt to highlight the basic information required in understanding and managing asthma and other allergic conditions. It is imperative to understand the health implications brought by numerous industrial effluents which are released in the environment without proper disposal management. Understanding the reasons for allergic condition, its genetic and environmental basis will enable people to take necessary actions and well-timed suitable preventive measures to avoid asthma and other allergic conditions. Works Cited "Advancing Research in Asthma". Web. 3 December 2013. . "Asthma Statistics". Web. 3 December 2013. . Hoffjan, S., Nicolae, D., Ober, C. "Association studies for asthma and atopic diseases: a comprehensive review of the literature". Respir Res. 4, 14. 2003. Gilmour, M.I., Jaakkola, M.S., London, S.J., Nel, A.E., Rogers, C.A. "How exposure to environmental tobacco smoke, outdoor air pollutants, and increased pollen burdens influences the incidence of asthma". Environ Health Perspect.114, pp. 627–633. 2006. "How is Asthma Diagnosed?" Web. 3 December 2013. . Khetsuriani, N., Lu, X., Teague, W. G., Kazerouni, N., Anderson, L. J., Erdman, D. D. "Novel Human Rhinoviruses and Exacerbation of Asthma in Children". Emerging Infectious Diseases. 14(11), pp. 1793-1796. 2008. Mihrshahi, S., Ampon, R., Webb, K., et al. "The association between infant feeding practices and subsequent atopy among children with a family history of asthma". Clin Exp Allergy. 37, pp. 671-9. 2007. Nagai, H. "Recent research and developmental strategy of anti-asthma drugs". Pharmacology and therapeutics. 133(1), 70-78. 2012. Tariq, S. M., Hakim E. A., Matthews, S. M. et al. "Influence of smoking on asthmatic symptoms and allergen sensitisation in early childhood". Postgrad. Med J. 76, pp. 694-9. 2000. Umetsu, D. T., DeKruyff, R. H. "The regulation of allergy and asthma". Immunological Reviews. 212, pp. 238-255. 2006. Yeatts, K., Sly, P., Shore, S., Weiss, S., Martinez, F., Geller, A., Bromberg, P., Enright, P., Koren, H., Weissman, D., Selgrade, M. J. "A Brief Targeted Review of Susceptibility Factors, Environmental Exposures, Asthma Incidence, and Recommendations for Future Asthma Incidence Research". Environmental Health Perspectives.114(4), pp. 634-640. 2006. Read More