What is Asthma?

Asthma
Morphology of the reticular basement membrane (Rbm) in asthma (A & B) compared to COPD (C & D). The Rbm, as indicated in A & B is located immediately beneath the true epithelial basement membrane (black arrows). A & B represent micrographs from airway biopsies in two asthma subjects. The Rbm is compact, homogenous and thickened in asthma. C & D represent micrographs from airway biopsies in two COPD subjects. In COPD the Rbm is non-homogenous, variable in thickness and fragmented. Vessels are seen contacting and partially or completely embedded within the Rbm in D. Vessels in the lamina propria are indicated with arrowheads. Bronchial biopsies, anti-Collagen IV antibody staining. Distinctive characteristics of bronchial reticular basement membrane and vessel remodelling in chronic obstructive pulmonary disease (COPD) and in asthma: they are not the same disease. Soltani A, Muller HK, Sohal SS, Reid DW, Weston S, Wood-Baker R, Walters EH - Histopathology (2012). Not Altered. CC.

Asthma is immunologic bronchoconstriction, inflammation, and mucus production due to increased airway sensitivity.

Types of asthma include: 

  • Atopic Asthma
  • Drug-Induced Asthma
  • Exercise-Induced Asthma
  • Non-Atopic Asthma
  • Occupational Asthma

What is the Pathology of Asthma?

The pathology of asthma is: 

-Etiology: The cause of asthma is, atopy, environmental factor including sensitizing chemicals, air pollution by allergens, or indoor allergens.

-Genes involved: ORMDL3 gene.

-Pathogenesis: The sequence of events that lead to asthma areas follows. Airway inflammation. Walls are infiltrated by inflammatory cells, eosinophils, neutrophils, plasma, cells, and lymphocytes which causes hyperemia, mucosal and submucosal edema. Intermittent airflow obstruction due to edema and finally bronchial hyperresponsiveness.

-Histology: The histology associated with asthma shows permeation of the inflammatory cells, airway lumina taping, mucus masses, and bronchial/bronchiolar epithelial stripping.

How does Asthma Present?

Patients with asthma typically a male-to-female ratio of 2:1 in children and 1:1 in adults, present at age range of 18 years. The symptoms, features, and clinical findings associated with asthma include chest tightness, wheezing, shortness of, breath and cough frequently worse at night.

How is Asthma Diagnosed?

Asthma is diagnosed through medical and physical examination, laboratory studies which include spirometry assessments, peak flow monitoring, sputum and  blood eosinophils.

How is Asthma Treated?

Asthma is treated through environmental control for allergens and pharmacologic treatment. 

What is the Prognosis of Asthma?

The prognosis of asthma is good with proper treatment and management.