Asthmatetic syndrome and its novel drug treatment

The origin of asthma can be traced to the complex-gene environment interactions. This results into three characteristic symptoms of asthma; variable airway obstruction, airway hyper-responsiveness, and airway inflammation. (Pynn, Thornton, & Davies, 2012). Asthma is a chronic disease of the lungs characterized by reversible airway obstruction due inflammation of the lungs’ airways and tightening of the airway muscles. Asthma is not a single disease but a complex mosaic of overlapping multiple separate syndromes (Pynn, Thornton, & Davies, 2012).

The underlying causes of asthma are not completely elucidated, and three forms exist. Allergic asthma (extrinsic asthma) this associated with an autoimmune response and starts in childhood and progresses into adulthood (Hales, 2005). Non-allergic asthma (intrinsic asthma) that is common among adults and is not associated with allergens; occupational asthma that is associated with exposure to fumes, gases, or dust. It can be extrinsic or intrinsic in nature and prevalent in individuals with an asthmatic history (Hales, 2005). The typical symptoms in all the types of asthma include; wheezing, shortness of breath, coughing, tightness of the chest, runny nose, eye irritation, and nasal congestion (Hales, 2005).

Asthma has no standardized approach for diagnosis; therefore, recommendations for the diagnostic tools and techniques are based on consensus among respiratory physicians. Diagnosis, however, is based on the history, physical examination, and supportive diagnostic testing (National Asthma Council Australia, 2006).

Several risk factors are associated with asthmatic symptoms, and the common ones are exposure to allergens, for example, from house dust mites, furry animals, pollen, or molds (Global Initiative for Asthma, 2011). In addition, exposure to occupational irritants, tobacco smoke, viral respiratory infections, strenuous exercise, strong emotions, chemical exposure, and drugs such as aspirin and β-blockers (Global Initiative for Asthma, 2011).

The pathogenesis of asthma is associated with two processes. First is airway inflammation. Asthmatic individuals are likely to develop inflammatory reactions with even harmless bacteria. This results into swelling, mucous production hence airway narrowing. The narrowing produces the asthmatic symptoms (Life Extension, 2014). Second is airway remodeling where bronchial tubes undergo structural changes during chronic uncontrolled attacks. Epithelial cells may shed away and allow penetration of allergens into the inner muscle cells. Sensory nerves may be exposed producing neural effects within the airways (Life Extension, 2014).

There is no cure for asthma; therefore, treatment involves management of symptoms. This involves taking anti-allergens and avoiding triggers to the asthma. A group of drugs are prescribed either alone or in combination and include; corticosteroids, long-acting beta-agonist  Leukotriene modifiers, and short-acting beta-agonists for quick relief (Agbetile & Green, 2010). However, the following new methods have emerged in the treatment and management of asthma and are patient focused. Self-management plan that provides asthma patients with a written asthma self-management or action plan. Stepwise incremental management where the patient increases the combination therapy after a period of three months and single maintenance and reliever therapy (SMART) that allow the combination use of LABA and Formoterol (Agbetile & Green, 2010).

Systemic corticosteroids have been found to have significant adverse effects prohibiting their long-term use. Therefore, new novel therapeutic approaches are utilized such as Anti-IgE therapy. Allergens of the asthmatic triggers and produce airway inflammation through the tendency of producing IgE (Agbetile & Green, 2010). The recombinant humanized monoclonal antibody Omalizumab is therefore, used as it attaches to the IgE receptors Fc∑RI binding free IgE hence reducing its circulation which down regulates its receptors leading to a reduction in the allergic responses in asthma (Agbetile & Green, 2010).

New information about asthma is being revealed and, therefore, its treatment is constantly evolving. The new information is providing opportunities for further development of asthma remedies and the emergence of new management strategies indicate the weaknesses of  previous methods, therefore, highlighting the need revise the existing methods in asthma management and treatment.

References

Agbetile, J., & Green, R. (2010). New Therapies and Management Strategies in the Treatment of             Asthma: Patient-Focused Developments. Journal of Asthma and Allergy , 4, 1-12.

Global Initiative for Asthma. (2011). Pocket Guide for Asthma Management and Treatment:                    A pocket Guide for Physicians and Nurses. Global Initiative for Asthma.

Hales, B. (2005, November 21). Types of Asthma and Their Clinical Features. Asthma Clinical                Features .

Life Extension. (2014). Life Extension. Retrieved March 13, 2014, from Life

National Asthma Council Australia. (2006). Asthma Management Handbook 2006 (11th Edition             ed.). Melbourne: National Asthma Council Australia.

Pynn, M. C., Thornton, C. A., & Davies, G. A. (2012). Asthma Pathogenesis. Artigo Original, 21            (2), 11-17.