Asthma characteristics

Vignolo, M. et al., Relationship between body mass index and asthma characteristics in a group of Italian children and adolescents, J. Asthma, 42, 185, 2005. 

Rashes, angioedema, serum sickness syndrome, anaphylaxis or asthma characteristics of classic protein allergy... 

It is helpful to differentiate inflammation occnrring in COPD from that present in asthma because the response to anti-inflammatory therapy differs. The inflammatory cells that predominate differ between the two conditions, with neutrophils playing a major role in COPD and eosinophils and mast cells in asthma. Mediators of inflammation also differ with LTB4, IL-8, and TNF-a predominating in COPD, compared with LTD4, IL-4, and IL-5 among the nnmer-ous mediators modulating inflammation in asthma. Characteristics of inflammation for the two diseases are summarized in Table 27-2. 

Asthma is an extremely complex condition characterized by variable and reversible airways obstmction combiaed with nonspecific bronchial hypersensitivity (1 3). The cause of asthma, which is not always readily diagnosed (4), remains unknown. Days, if not weeks, ate needed to document the spontaneous reversal of the airways obstmction ia some patients. Asthmatics experience both an immediate hypersensitivity response and a delayed late-phase reaction, each mediated by a different pathway. Chronic asthma has come to be viewed as an inflammatory disease (5). The late-phase reaction plays a key role ia iaduciag and maintaining the inflammatory state which ia turn is thought to iaduce the bronchial hyperresponsiveness (6). The airways obstmction results from both contraction of airways smooth muscle and excessive bronchial edema. Edema, a characteristic of inflammatory states, is accompanied, ia this case, by the formation of a viscous mucus which can completely block the small airways. 

RESPIRATORY SENSITIZER (asthmagen) A substance which can cause an individual s respiratory system to develop a condition which makes it over-react if the substance is inhaled again. Such an individual is sensitized over-reaction is then likely to occur at concentrations of the substance which have no effect on unsensitized persons and lead to characteristic symptoms, e.g. rhinitis (a runny nose), conjunctivitis or in severe cases asthma or alveolitis. 

Airway inflammation is a characteristic clinical feature of asthma. The distinction between the LAR and chronic inflammation becomes more difficult as the disease progresses. Infiltrated leukocytes release ototoxic mediators such as reactive oxygen species (ROS) and cationic (basic) proteins causing epithelial damage and cyfo/cmas that perpetuate the inflammation. Sustained inflammation leads to airway hyperrespon-siveness and airway remodeling. 

AIA runs a characteristic clinical course [9]. It is more frequent in women than men, and is unusual in children, beginning in adulthood, on average at the age of 30 years. Rhinorrhea and nasal congestion are usually the first symptoms, subsequently complicated by polyposis. Asthma and aspirin hypersensitivity develop 2-15 years later. Once developed, aspirin intolerance remains through life, although sporadic disappearance of intolerance has been reported. Asthma, characterized by blood and nasal eosinophilia, rims a protracted course despite avoidance of analgesics. In about half the patients, the course of asthma is severe, necessitating use of systemic corticosteroids. 

Airway hyperresponsiveness is defined as the exaggerated ability of the airways to narrow in response to a variety of stimuli. Although AHR exists in patients without asthma, it is a characteristic feature of asthma and appears to be directly related to airway inflammation and the severity of asthma.1,3 Treatment of airway inflammation with inhaled corticosteroids attenuates AHR in asthma but does not eliminate it.1 Clinically, AHR manifests as increased variability of airway function. Although not commonly used to diagnose asthma, AHR can be evaluated clinically using a methacholine or histamine bronchoprovocation test. 

Asthma is characterized by variable symptoms such as wheeze, shortness of breath and coughing and is usually associated with airway inflammation, with variably reduced spirometric indices [4, 5], with increased non-specific airway responsiveness (AR) to spasmogens [6, 7] and increased levels of semm immunoglobulin E (IgE) and eosinophils [8-10]. The symptoms of asthma are primarily due to excessive airway narrowing, which leads to an increased resistance to airflow, especially during forced expiration, and produces characteristic spirometric findings. A cardinal feature of asthma is that airway narrowing is reversible either spontaneously or as the result of therapy. 

The major characteristics of asthma include a variable degree of airflow obstruction (related to bronchospasm, edema, and hypersecretion), BHR, and airway inflammation. 

Janssen EM. van Oosterhout AJ, van Rensen AJ. van Eden W. Nijkamp FP. Wauben MH Modulation of Th2 responses by peptide analogues in a murine model of allergic asthma amelioration or deterioration of the disease process depends on the Thl or Th2 skewing characteristics of the therapeutic peptide. J Immunol 2000 164 580-588. 

The EPA is conducting a major study in the Los Angeles basin on the effects of photochemical oxidants on health. It is a survey of schoolchildren in seven communities representing a gradient of oxidant exposure. In addition to comprehensive environmental monitoring data, specific health characteristics will be followed, including chronic respiratory disease in adults, lower respiratory disease in children, acute respiratory disease in both children and adults, pulmonary function in children, aggravation of asthma, irritation of mucous membranes, and tissue residues of trace metals. Complete data from this study will not be available for another 3 yr, but data from the first 2 yr may become available sooner. 

General Medical Conditions that Resemble Panic Attacks. Panic attacks are characterized by the abrupt onset of characteristic physical symptoms such as chest pain, shortness of breath, profnse sweating, dizziness, andnansea. Such symptoms may also be caused by severe and even life-threatening medical conditions such as asthma, emphysema, strokes, aneurysms, and heart attacks. It is, in fact, the fear that they re having a heart attack or some other severe medical problem that leads many patients to seek treatment after a panic attack. 

Wu, A. Y., and Williams, G. A. (2004). Clinical characteristics and pattern of skin test reactivities in shellfish allergy patients in Hong Kong. Allergy Asthma Proc. 25, 237-242. Yamura, T., and Kurose, H. (1966). Oyster-shucker s dermatitis. Arerugi 15, 813. 

An aberrant immune response associated with allergy appears to underlie asthma in most children over age 3 years and in most young adults allergy-induced asthma is also known as extrinsic asthma. In contrast, a large number of patients, especially those who acquire asthma as older adults, have no discernible immunological basis for their condition, although airway inflammation remains a characteristic of the disease this type of... 

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