ASTHMA

Disease

Brief Summary

Asthma is a condition where the respiratory tract shrinks and swells. It may also produce extra mucus and can make breathing difficult, trigger coughing, wheezing, and shortness of breath. For certain individuals, asthma is a minor problem. There is no clinical treatment to cure asthma. Patients must visit their doctors to keep track of their medications.

Source

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Person affected by Asthma

Frequency

Approximately 235 million people worldwide have asthma. In the United States, the condition affects an estimated 8 percent of the population

According to the World Health Organization (WHO), 12 percent of the Philippines' 90 million people have asthma, while the Global Asthma Report estimates that 11 million people, or one out of every ten, have asthma. However, 98 percent of Filipino asthma sufferers remain untreated.

Inheritance

Asthma is a complex and multifactorial disease, meaning that it is influenced by both genetic and environmental factors (exposure to allergens, pollutants, and etc.). The inheritance pattern of asthma is not straightforward and can be influenced by multiple genes involved in various biological processes, such as immune response, inflammation, and airway function.

Brief Summary

History of Disease

Primary sources such as scriptures and various art forms mentioned asthmas far back as 2,600 B.C.E. The disease then was formally named and described by Hippocrates in Greece 2000 years later. He is the first to establish the notion to link asthma symptoms to environment triggers. The condition is further elucidated by Aristaeus of Cappadocia, he composed a thorough definition of asthma that was similar to the contemporary understanding of how the disease progresses. Romans also explored the ailment, around 50 A.C.E. Pliny the Elder associated pollen and breathing difficulties. He was the first to suggest to use the predecessor of epinephrine (hormonal drug for quick relief and treatment for respiratory issues). The diagnosis of asthma has changed over time as technology progresses.

Pathogenesis

Achondroplasia is caused by a mutation in the FGF3 gene in chromosome 4 at 4p 16.3. This mutation causes a decreased production of fibroblast growth factor receptor 3 which is crucial in the conversion of cartilage into bone which is vital in the proper development of a person. This mutation is inherited in an autosomal dominant manner. More than 80 percent of people with achondroplasia have parents with normal characteristics and are born with achondroplasia due to a recent (de novo) gene modification (mutation).

Pathogenesis

Scientists have not pinned on the specific gene that causes asthma given that it is a complex genetic disorder, meaning multiple genes account to the rise of the disorder, as well as different environmental factors. A person whose family has a history of asthma has a higher risk of developing asthma. However, its inheritance pattern is not known yet. It should be noted that not all persons with a mutated gene associated with asthma will develop the disorder given many other genes and environmental factors can be accounted for this occurrence.

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Mechanism that causes Asthma

Symptoms

chest tightness

coughing, especially at night or early morning

shortness of breath

wheezing

Asthma attacks or exacerbations are incidents that are caused by the worsening of the symptoms. It can come on gradually or suddenly and may be life-threatening. This happens more often among patients with severe asthma.

Social Concerns

There are some individuals who are hesitant to use their inhalers in public, especially among young individuals. They tend to keep their condition hidden in an attempt to fit in along with the others. Asthma in the media tends to get associated with weakness since it is known as the weak “wimpy” character that has the disorder. Although, in reality, many athletes also live with asthma and are fine. This stigma could create an environment where the patient can be misjudged and become insecure themselves about their condition.

Clinical Trials

Treatment

There is no clinical treatment to cure asthma. However, there is medication prescribed to effectively control the disorder. It is known to be a chronic disorder. Thus, the individual must regularly monitor oneself. Knowing one’s triggers and assessing one’s conditions for the right type of medication is the first step to proper management. The type and dosage for asthma medication will vary depending on age, severity of the disorder, and medication side effects. Patients must regularly visit their doctor to keep track of their current conditions and adjust medication when necessary.

Types of asthma medications:

Long-term asthma control medications

Inhaled corticosteroids
Leukotriene modifiers
Long-acting beta-agonists (LABAs)
Theophylline
Combination inhalers that contain both a corticosteroid and a LABA

Quick-relief medications

(rescue medications)

Short-acting beta-agonists such

as albuterol

Ipratropium (Atrovent)
Oral and intravenous corticosteroids
(for serious asthma attacks)

Medications for

allergy-induced asthma

Allergy shots (immunotherapy)
Allergy medications

Biologics

Omalizumab (Xolair)
Mepolizumab (Nucala)
Benralizumab (Fasenra)
Reslizumab (Cinqair)

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Treatment for Asthma

Clinical Trials

Title:

Aerosolized Beta-Agonist Isomers in Asthma

Intervention:

Drug: levalbuterol

0.5 ml. levalbuterol

Drug: saline

0.5ml saline

Other: levalbuterol MDI

Device: breath actuated nebulizer

Device: aerochamber max

Drug: ipratroprium

Phase:

Phase 4

Procedure:

Patients will be studied on five separate mornings. The duration of the study and frequency of the visits will be solely dependent on the subject availability. Each subject will receive all 5 treatments in the same order.

Goal:

The purpose of this study is to deliver these new medications using several different devices and measuring lung function, heart rate, and sensations of breathlessness.

Further details at:

https://clinicaltrials.gov/ct2/show/record/NCT02170532?cond=Asthma&draw=2&rank=24

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