Asthma is a chronic inflammatory disease which attacks the airways of the respiratory system, resulting in reduction or even blocking the flow of air. Its pathophysiology is related to interaction between genetic and environmental factors that manifest as attacks of breathlessness due to swelling of the bronchial mucosa, the overproduction of mucus in the airways and contraction of airway smooth muscle, with consequent reduction of its diameter ( bronchospasm).
Crises are characterized by various symptoms such as dyspnea, coughing and wheezing, especially at night. The narrowing of the airways is usually reversible, but in patients with chronic asthma, the inflammation can determine irreversible airflow obstruction.
In many cases this disease can be triggered by allergic processes, which through frequent exposure to allergens the individual can hiperestimular your immune system and cause sensitization active producing therefore the appearance of Allergic Bronchial Asthma.
To understand this process we will study each topic step by step and understand how to produce their appearance.
DEFINITION OF ALLERGY
The allergy is an exaggerated immune response to a foreign substance to the body, ie an immune hypersensitivity to a specific external stimulus. Patients with allergies are called “atopic” or more popularly “allergic”.
There are at least 30 years of studies on this disease that affects millions of people around the world. The major concerns of the medical clinic for asthma in children are still in school, which are in an initial contact with external agents and some allergic substances known as allergens found in pollen of plants, animal epithelia (hair and dandruff) and protein some insects such as bees.
It was believed at first that these allergens were responsible for the production of so-called “Broncos-spasms” which is one of the main villains of this disease. Some time later it was discovered that they are responsible, yes, but not for production, if not, responsible for triggering this process the body’s defense. The process is simple, but we need to understand detail the process from submission to final stage.
As we already know the allergen or allergens that are responsible for triggering this process must be presented to the human body. Several factors are responsible or not for these events, among them genetic factors (Chromosome 5Q) that makes these individuals prone to develop this process. When a substance allergic our organism enters the first time, either by mouth, skin or respiratory level some cells is of fundamental importance in this process.
PROCESS OF RAISING
Let’s take an example at how breathing or starts this process. The first cell responsible for capturing this antigen (allergic substance) to enter the airway and provide the cellular defense system (immune system) are Dendritic Cells. These cells substance to the cell such that subsequent chain called T-Lymphocyte (CD4 +) engaging this antigen to its cellular receptor known as the TCR (T-cell receptor). This last cell will analyze this substance chemically and inform a helpline phone call LTh2 (Lymphocyte T – Helper II). The LTh2, after understanding a chemical message (cytokine) of LT (CD4 +) will stimulate some cells through the production and release of a substance called interleukin (IL-4) that will stimulate the B lymphocytes (cell humoral) to produce a specific antibody allergic to this substance called IgE (Immunoglobulin E), while also LTh2 this cell will also produce and release another interleukin (IL-5) that will activate and recruit Eosinophils (immune cells, mediators of inflammation). At this stage the bronchial epithelium will also secrete another substance called “eotaxin” which will maximize the effect of IL-5 by activating and recruiting more Eosinophils that later will release Leukotrienes, Prostaglandins and Eicosanoids. With the active IgE antibody in the body it will look for other cells, called mast cells. The immunoglobulins will stick to the membrane of specific receptors on mast cells called FC. The whole process, is known as Phase Awareness.
When the time of exposure to this antigen (allergic substance) is prolonged and continuous we move to the acute phase of the allergic process which is when the individual already has touched the second contact with the substance. In this second entry dendritic cells can no longer participate allowing entry to the body of the substance to be captured by those immediately active mast cells by IgE antibodies in their membrane.
When do you join this antigen to the antibody attached to mast cells, a reaction occurs which causes the lysis (rupture) of the cell membrane, and as such are loaded with histamine, a substance that will get H1 receptors in capillaries and bronchi, which will produce important changes at the systemic level. Bronchoconstriction capillary vasodilation and respiratory mucus hypersecretion. These processes will stimulate and encourage the formation of edema, migration of inflammatory type cells from the bloodstream to initiate a process of phagocytosis of these allergens.
These changes form part of the defense of our body, unfortunately we are dealing with an exaggerated manifestation of our body which causes damage against himself. The problem is that the “fear” of our organism to these substances often ends up being greater than the problem that they themselves can produce.
Together with inflammation, edema formation will (accumulation of fluid in interstitial space). This process becomes with each passing hour more chronic and when there is a blockage it can end up producing tissue damage that ultimately will be repaired by fibroblasts and corrected by tissue fibrosis.
COMPLICATIONS OF ASTHMA
In the case of Bronchial Asthma, it is important to alert the two key problems: Bronchoconstriction and hypersecretion of Moco, one fatality for an asthma patient, as these factors would preclude this patient to breathe, a fact that if not treated can lead to death. This is where we learn more about the function of an antihistamine and steroids. Antihistamines are drugs (substances) that will cover (blocking) these receptors H1 from being stimulated by histamine to produce such devastating effects. And steroids will struggle against excessive bronchoconstriction, reversing this frame and producing a bronchodilation, allowing the passage of air and secretion, which will allow good breathing and oxygenation of the patient and removal of these particles by ciliary movement of secretion and bronchi taking this substance out of the bronchial tree so that it does not continue stimulating allergic response.
Other drugs such as corticosteroids also have a role in the treatment of this disease. It is always important for patients suffering from this disease, consult your pulmonologist, he will know to make an accurate early diagnosis and classify the disease in Mild, Moderate and Severe.
The types of treatments are recommended:
- Control of the allergen (the substance to determine);
- Reduce the time of exposure to the agent;
- Assess Environment and Climatic factors;
- Treatment with drugs (antihistamines, corticosteroids and steroids).
In 90% of cases the patient can cure the disease when the acknowledgment is made in infancy through a proper diagnosis and timely treatment of this patient. In adulthood can not cure the disease, what is sought is to make an environmental control over the patient’s exposure to the causative agent and its management climate. Asthmatic patients living with serious problems in the humid and cold. In these cases the patient is indicated regions get hotter and drier with less change in temperature. With these discas is possible to live well with the disease and let the asthmatic crises far.
“I remind you again that I do not usually mention the name of medication and dosage may influence patients to opt for self-medication, since each case must be studied to determine the origin of asthma and in the same condition and determine stage or chronicity of asthma. These determinations can not be made only by statements, but requires the presence of a professional to make appropriate diagnosis through anamnesis and laboratory assistance when needed. After these procedures we can determine what kind of treatment this patient can follow. “