atopic asthma

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Related to atopic asthma: atopic dermatitis, intrinsic asthma


a condition marked by recurrent attacks of dyspnea, with airway inflammation and wheezing due to spasmodic constriction of the bronchi; it is also known as bronchial asthma. Attacks vary greatly from occasional periods of wheezing and slight dyspnea to severe attacks that almost cause suffocation. An acute attack that lasts for several days is called status asthmaticus; this is a medical emergency that can be fatal. adj., adj asthmat´ic.
Causes. Asthma can be classified into three types according to causative factors. Allergic or atopic asthma (sometimes called extrinsic asthma) is due to an allergy to antigens; usually the offending allergens are suspended in the air in the form of pollen, dust, smoke, automobile exhaust, or animal dander. More than half of the cases of asthma in children and young adults are of this type. Intrinsic asthma is usually secondary to chronic or recurrent infections of the bronchi, sinuses, or tonsils and adenoids. There is evidence that this type develops from a hypersensitivity to the bacteria or, more commonly, viruses causing the infection. Attacks can be precipitated by infections, emotional factors, and exposure to nonspecific irritants. The third type of asthma, mixed, is due to a combination of extrinsic and intrinsic factors.

There is an inherited tendency toward the development of extrinsic asthma. It is related to a hypersensitivity reaction of the immune response. The patient often gives a family medical history that includes allergies of one kind or another and a personal history of allergic disorders. Secondary factors affecting the severity of an attack or triggering its onset include events that produce emotional stress, environmental changes in humidity and temperature, and exposure to noxious fumes or other airborne allergens.
Symptoms. Typically, an attack of asthma is characterized by dyspnea and a wheezing type of respiration. The patient usually assumes a classic sitting position, leaning forward so as to use all the accessory muscles of respiration. The skin is usually pale and moist with perspiration, but in a severe attack there may be cyanosis of the lips and nailbeds. In the early stages of the attack coughing may be dry; but as the attack progresses the cough becomes more productive of a thick, tenacious, mucoid sputum.
 An asthma attack with respiratory distress. From Frazier et al., 2000.
Treatment. The treatment of extrinsic asthma begins with attempts to determine the allergens causing the attacks. The cooperation of the patient is needed to relate onset of attacks with specific environmental substances and emotional factors that trigger or intensify symptoms. The patient with nonallergic asthma should avoid infections, nonspecific irritants, such as cigarette smoke, and other factors that provoke attacks.

Drugs given for the treatment of asthma are primarily used for the relief of symptoms. There is no cure for asthma but the disease can be controlled with an individualized regimen of drug therapy coupled with rest, relaxation, and avoidance of causative factors. Bronchodilators such as epinephrine and aminophylline may be used to enlarge the bronchioles, thus relieving respiratory embarrassment. Other drugs that thin the secretions and help in their ejection (expectorants) may also be prescribed.

The patient with status asthmaticus is very seriously ill and must receive special attention and medication to avoid excessive strain on the heart and severe respiratory difficulties that can be fatal.
Patient Care. Because asthma is a chronic condition with an irregular pattern of remissions and exacerbations, education of the patient is essential to successful treatment. The plan of care must be highly individualized to meet the needs of the patient and must be designed to encourage active participation in the prescribed program and in self care. Most patients welcome the opportunity to learn more about their disorder and ways in which they can exert some control over the environmental and emotional events that are likely to precipitate an attack.

Exercises that improve posture are helpful in maintaining good air exchange. Special deep breathing exercises can be taught to the patient so that elasticity and full expansion of lung and bronchial tissues are maintained. (See also lung and chronic obstructive pulmonary disease.) Some asthmatic patients have developed a protective breathing pattern that is shallow and ineffective because of a fear that deep breathing will bring on an attack of coughing and wheezing. They will need help in breaking this pattern and learning to breathe deeply and fully expand the bronchi and lungs.

The patient should be encouraged to drink large quantities of fluids unless otherwise contraindicated. The extra fluids are needed to replace those lost during respiratory distress. The increased intake of fluids also can help thin the bronchial secretions so that they are more easily removed by coughing and deep breathing.

The patient should be warned of the hazards of extremes in eating, exercise, and emotional events such as prolonged laughing or crying. The key words are modification and moderation to avoid overtaxing and overstimulating the body systems. Relaxation techniques can be very helpful, especially if the patient can find a method that effectively reduces tension.

Asthmatic patients fare better if they feel that they do have some control over their disease and are not necessarily helpless victims of a debilitating incurable illness. There is no cure for asthma but there are ways in which one can adjust to the illness and minimize its effects.
allergic asthma (atopic asthma) that due to an atopic allergy; see asthma.
bronchial asthma asthma.
cardiac asthma a term applied to breathing difficulties due to pulmonary edema in heart disease, such as left ventricular failure.
extrinsic asthma
asthma caused by some factor in the environment, usually atopic in nature.
intrinsic asthma that due to a chronic or recurrent infection; see asthma.
occupational asthma extrinsic asthma due to an allergen present in the workplace.

a·top·ic asth·ma

bronchial asthma caused by atopy.

Patient discussion about atopic asthma

Q. How can I prevent my future Children from Inheriting my Allergies / Allergic Asthma? I have Allergies & Allergic ASTHMA, I have read about Childhood “Allergic MARCH " ... Is there ANYTHING my Husband & I can do before conception to prevent my Children from inheriting this terrible Disease?

A. does your husband have allergy in his family too? Allergies are environmental at least as much as they are genetic. There is the “hygiene hypothesis” that suggest allergies caused by lack of encounters of our immune system and pathogens. For example- There is a new experimental treatment that they insert a harmless parasite into your body and cause your immune system to react and “shift” it from one type of reaction to another.
Info about hygiene hypothesis:

More discussions about atopic asthma
References in periodicals archive ?
We found expression for mRNA of IL-22-BP in PBMCs from individuals with atopic asthma and healthy controls after incubation with IL-4 (after an incubation period of 12 hours, IL-22 BP expression hold on up to 96 hours).
The concentration of allergen-specific IgE to the allergen component d1 was more than 70.0 kUA/l in 4 patients, two of whom had combined severe persistent atopic asthma and allergic conjunctivitis.
This clinical study found that the level of airway inflammation in children with atopic asthma was reduced, and that Plasmacluster Ion technology(2) will contribute to human health in an actual living environment.
The second study demonstrates that all allergic or asthmatic associations in mothers are poor predictors of atopic asthma in their children; the descriptive statistics were low for all maternal factors.
2000) have shown only a weak protective effect against asthma itself, or they have shown a dual response in children with atopic asthma and allergy to be lower with increasing LPS exposure, and contrary to this, an increased prevalence of nonatopic wheeze with increasing LPS exposure (Braun-Fahrlander et al.
"This receptor is central to the development of diagnostic methods, research tools, and most importantly, new therapies for atopic asthma, allergy and other IL-9 related diseases.
This protein has been already evaluated in atopic asthma and rhinitis, demonstrating its role in these diseases [17-19].
We analysed cross-sectional and longitudinal uEPX data from a long-term follow-up study in children with atopic asthma [14].
Atopic asthma (inflammation of the airways caused by exposure to airborne allergens) has become increasingly prevalent since the 1960s and is now the most common chronic childhood disease in the United States and many other industrialized countries.
Omalizumab is approved for atopic asthma only, and that means to be reimbursed for this expensive agent there must be concrete evidence of atopy, either from radioallergosorbent testing or a skin prick test.
-- Vitamin E supplementation in adult patients with atopic asthma did not improve bronchial reactivity, according to a poster presentation at the 100th International Conference of the American Thoracic Society.
-- Vitamin E supplementation in adult patients with atopic asthma did not lead to reductions in bronchial reactivity, according to a poster presentation at the 100th International Conference of the American Thoracic Society.