reactive airway disease


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bron·chi·al asth·ma

an acute or chronic disorder characterized by widespread and largely reversible reduction in the caliber of bronchi and bronchioles, due in varying degrees to smooth muscle spasm, mucosal edema, and excessive mucus in the lumens of airways. Cardinal symptoms are dyspnea, wheezing, and cough. Attacks or exacerbations may be induced by airborne allergens (for example, molds, pollens, animal dander, dust mite and cockroach antigens), inhaled irritants (for example, cold air, cigarette smoke, ozone), physical exercise, respiratory infection, psychological stress, or other factors. The signs and symptoms of bronchial asthma are caused by the local release of spasmogens and inflammatory mediators (for example, histamines, leukotrienes, prostaglandins) and other substances from mast cells, eosinophils, lymphocytes, neutrophils, and epithelial cells. Airway caliber may be abruptly and drastically reduced during a paroxysm or after diagnostic challenge with methacholine or histamine, and may quickly return to normal after administration of a bronchodilator (for example, inhaled β-adrenergic agonist or subcutaneous epinephrine).

Asthma is a common disorder, with a prevalence of about 5% in the U.S., and a leading cause of illness and disability in people between 2 and 17 years of age. It is responsible for 14.5 million outpatient visits and 5,000 deaths yearly in this country. The prevalence of asthma has been increasing during the past 25 years, particularly in children under age 5. Asthma first occurring in childhood is more likely to be allergic in origin and to show seasonal variation. Chronic sinusitis and gastroesophageal reflux disease are statistically correlated with asthma. A subset of people with allergic asthma also have nasal polyps and sensitivity to aspirin and other nonsteroidal antiinflammatory drugs (Samter triad). Occupational exposure to airborne irritants or allergens causes at least 10% of chronic asthma in adults. Current views of the pathophysiology of asthma emphasize its inflammatory component and the risk of gradual, irreversible airway remodeling due to subepithelial fibrosis in poorly controlled asthma. Interleukin 13 has been implicated as a mediator of such fibrosis, and the presence of antibody to Chlamydia pneumoniae has been linked statistically to accelerated deterioration of lung function in patients with asthma. Current recommendations for treatment of chronic or severe asthma call for use of antiinflammatory drugs (particularly inhaled corticosteroids). Other treatments include β2-adrenergic bronchodilators (albuterol, terbutaline, salmeterol), xanthines (theophylline, oxtriphylline, dyphylline), mast cell stabilizers (cromolyn, nedocromil), and antileukotrienes (montelukast, zafirlukast, zileuton). Self-monitoring of peak respiratory flow rate with a simple portable device helps patients adjust drug doses for optimal effect. Avoidance of allergens, irritants, and other known triggers is essential to good control.

reactive airway disease

Any disease in which there is reversible bronchospasm, such as asthma. See: asthma
References in periodicals archive ?
In summary, otolaryngologists/allergists have an active role in treating patients' asthma because of the high incidence of a concurrent diagnosis with the same patient population who suffer from allergy, reactive airway disease, and chronic sinus disease.
Radiogra-phy is irrelevant under a clinical suspicion of reactive airway disease.
C pneumoniae seroreactivity was associated with both acute and chronic wheezing, suggesting that pulmonary infection with this intracellular pathogen plays a role in the natural history of reactive airway disease.
Deposition and Pharmacokinetic Studies with Inhaled P2Y2 Agonists - Evidence of High Lung Delivery and Minimal Systemic Exposure Poster presentation on Thursday and Friday, June 14-15, 2007 and oral presentation on Thursday, June 14, 2007 -- Reactive Airway Disease and Cystic Fibrosis: a Retrospective Analysis of the Safety and Tolerability with Denufosol Inhalation Solution Poster presentation on Thursday, June 14, 2007 and guided poster tour on Friday, June 15, 2007
Her parents denied any history of reactive airway disease, significant atopy, or symptoms of recent upper respiratory infection.
Staff felt that factors contributing to the high readmission rate included family anxiety and lack of education about caring for their child at home, medical conditions such as reactive airway disease, and resource issues such as living remotely.
We discuss a case of ectopic intratracheal thyroid tissue that was diagnosed only after decades of failed treatment for reactive airway disease.
Drug of choice for patients with reactive airway disease (bronchial asthma) because of its selectivity, but must be used with caution in such patients.
In one study of cold-air challenge testing that included some patients with no history of reactive airway disease, the prevalence was 73%.
Pathophysiology of reactive airway disease and sinusitis.
Some prior studies--albeit open-label and uncontrolled--have suggested that treatment of acute atypical bacterial infection improves the long-term course of reactive airway disease, so it seemed to be an appropriate time to test the novel therapy using a more definitive, double-blind, randomized study design, explained Dr.