Moonhee Lee, M.D.               

Allergy and Asthma Center


Asthma


Asthma is defined as lower airway narrowing that is reversible either spontaneously or with treatment. Airway narrowing is primarily from inflammation causing swelling of the bronchial wall and mucous plug formation. Besides inflammation, contraction of the bronchial muscle (bronchospasm) causes additional narrowing of the airway.  SYMPTOMS OF ASTHMA include wheezing (whistling), shortness of breath, chest tightness, and coughing. In some people, coughing is the only symptom of asthma (cough variant asthma).  CAUSES OF ASTHMA vary depending on age. In children, the vast majority of asthma is caused by allergy. Allergens (things that cause allergy) include pollens (trees, grass, weeds) dust mites, animal hair or danders (cat, dog) and molds (fungi). In adult onset asthma, less that 50% of cases are related to allergies. Other triggers of asthma include viral upper respiratory infections, sinusitis, weather changes, irritants such as cigarette smoke and pollution, sensitivity to drugs such as aspirin, emotional stress, gastroesophageal reflux and exercise.  TREATMENTS  There are three basic types of treatment available to asthma sufferers: Avoidance, Drug Therapy and Immunotherapy. Avoidance is the least expensive and simplest way to manage asthma. It involves eliminating irritants or allergens such as dust mites and animal danders. There are two types of medications that are currently prescribed for asthma; anti-inflammatory medications and bronchodilators. Anti-inflammatory medications reduce swelling and mucus in the airway. Cromolyn sodium, Nedocromil, leukotriene inhibitors and corticosteroids belong to this category. Bronchodilators stretch the bronchial muscle temporarily but do not reduce swellings. These include beta-agonists (e.g., albuterol), Atrovent and theophyllines. Many asthma medications are available in the form of inhalers or solution for nebulizer giving maximum effect on the lungs while minimizing the side effects.  IMMUNOTHERAPY consists of a series of injections with a solution containing allergens that one is allergic to. Immunotherapy reduces and prevents allergic inflammation and therefore prevents swelling and mucous plugging in the airway. Immunotherapy does not work for all asthma cases. It is indicated in asthma only if allergy plays a major role.