Asthma

Asthma
Two white plastic tubes with movable dials on the front
Peak flow meters are used to measure the peak expiratory flow rate, important in both monitoring and diagnosing asthma.[1]
Pronunciation
  • UK: /ˈæsmə, ˈæsθmə/
  • US: /ˈæzmə/[2][3]
SpecialtyPulmonology
SymptomsRecurring episodes of wheezing, coughing, chest tightness, shortness of breath[4]
ComplicationsGastroesophageal reflux disease (GERD), sinusitis, obstructive sleep apnea
Usual onsetChildhood
DurationLong term[5]
CausesGenetic and environmental factors[4]
Risk factorsAir pollution, allergens[5]
Diagnostic methodBased on symptoms, response to therapy, spirometry[6]
TreatmentAvoiding triggers, inhaled corticosteroids, salbutamol[7][8]
Frequencyapprox. 262 million (2019)[9]
Deathsapprox. 461,000 (2019)[9]

Asthma is a long-term inflammatory disease of the airways of the lungs.[5] It is characterized by variable and recurring symptoms, reversible airflow obstruction, and easily triggered bronchospasms.[10][11] Symptoms include episodes of wheezing, coughing, chest tightness, and shortness of breath.[4] These may occur a few times a day or a few times per week.[5] Depending on the person, asthma symptoms may become worse at night or with exercise.[5]

Asthma is thought to be caused by a combination of genetic and environmental factors.[4] Environmental factors include exposure to air pollution and allergens.[5] Other potential triggers include medications such as aspirin and beta blockers.[5] Diagnosis is usually based on the pattern of symptoms, response to therapy over time, and spirometry lung function testing.[6] Asthma is classified according to the frequency of symptoms, forced expiratory volume in one second (FEV1), and peak expiratory flow rate.[12] It may also be classified as atopic or non-atopic, where atopy refers to a predisposition toward developing a type 1 hypersensitivity reaction.[13][14]

There is no known cure for asthma, but it can be controlled.[5] Symptoms can be prevented by avoiding triggers, such as allergens and respiratory irritants, and suppressed with the use of inhaled corticosteroids.[7][15] Long-acting beta agonists (LABA) or antileukotriene agents may be used in addition to inhaled corticosteroids if asthma symptoms remain uncontrolled.[16][17] Treatment of rapidly worsening symptoms is usually with an inhaled short-acting beta2 agonist such as salbutamol and corticosteroids taken by mouth.[8] In very severe cases, intravenous corticosteroids, magnesium sulfate, and hospitalization may be required.[18]

In 2019 asthma affected approximately 262 million people and caused approximately 461,000 deaths.[9] Most of the deaths occurred in the developing world.[5] Asthma often begins in childhood,[5] and the rates have increased significantly since the 1960s.[19] Asthma was recognized as early as Ancient Egypt.[20] The word asthma is from the Greek ἆσθμα, âsthma, which means 'panting'.[21]

  1. ^ GINA 2011, p. 18
  2. ^ Jones D (2011). Roach P, Setter J, Esling J (eds.). Cambridge English Pronouncing Dictionary (18th ed.). Cambridge University Press. ISBN 978-0-521-15255-6.
  3. ^ Wells JC (2008). Longman Pronunciation Dictionary (3rd ed.). Longman. ISBN 978-1-4058-8118-0.
  4. ^ a b c d Drazen GM, Bel EH (2020). "81. Asthma". In Goldman L, Schafer AI (eds.). Goldman-Cecil Medicine. Vol. 1 (26th ed.). Philadelphia: Elsevier. pp. 527–535. ISBN 978-0-323-55087-1.
  5. ^ a b c d e f g h i j "Asthma Fact sheet №307". WHO. November 2013. Archived from the original on June 29, 2011. Retrieved March 3, 2016.
  6. ^ a b Lemanske RF, Busse WW (February 2010). "Asthma: clinical expression and molecular mechanisms". The Journal of Allergy and Clinical Immunology. 125 (2 Suppl 2): S95-102. doi:10.1016/j.jaci.2009.10.047. PMC 2853245. PMID 20176271.
  7. ^ a b NHLBI Guideline 2007, pp. 169–72
  8. ^ a b NHLBI Guideline 2007, p. 214
  9. ^ a b c "Asthma–Level 3 cause" (PDF). The Lancet. 396: S108–S109. October 2020.
  10. ^ NHLBI Guideline 2007, pp. 11–12
  11. ^ GINA 2011, p. 20,51
  12. ^ Yawn BP (September 2008). "Factors accounting for asthma variability: achieving optimal symptom control for individual patients" (PDF). Primary Care Respiratory Journal. 17 (3): 138–147. doi:10.3132/pcrj.2008.00004. PMC 6619889. PMID 18264646. Archived (PDF) from the original on March 26, 2009.
  13. ^ Kumar V, Abbas AK, Fausto N, Aster J (2010). Robbins and Cotran pathologic basis of disease (8th ed.). Saunders. p. 688. ISBN 978-1-4160-3121-5. OCLC 643462931.
  14. ^ Stedman's Medical Dictionary (28 ed.). Lippincott Williams & Wilkins. 2005. ISBN 978-0-7817-3390-8.
  15. ^ GINA 2011, p. 71
  16. ^ GINA 2011, p. 33
  17. ^ Scott JP, Peters-Golden M (September 2013). "Antileukotriene agents for the treatment of lung disease". American Journal of Respiratory and Critical Care Medicine. 188 (5): 538–44. doi:10.1164/rccm.201301-0023PP. PMID 23822826.
  18. ^ NHLBI Guideline 2007, pp. 373–75
  19. ^ Anandan C, Nurmatov U, van Schayck OC, Sheikh A (February 2010). "Is the prevalence of asthma declining? Systematic review of epidemiological studies". Allergy. 65 (2): 152–67. doi:10.1111/j.1398-9995.2009.02244.x. PMID 19912154. S2CID 19525219.
  20. ^ Manniche L (1999). Sacred luxuries: fragrance, aromatherapy, and cosmetics in ancient Egypt. Cornell University Press. pp. 49. ISBN 978-0-8014-3720-5.
  21. ^ Murray JF (2010). "Ch. 38 Asthma". In Mason RJ, Murray JF, Broaddus VC, Nadel JA, Martin TR, King Jr TE, Schraufnagel DE (eds.). Murray and Nadel's textbook of respiratory medicine (5th ed.). Elsevier. ISBN 978-1-4160-4710-0.

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